Calcium gluconate
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Names | |
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IUPAC name
calcium (2R,3S,4R,5R)- 2,3,4,5,6-pentahydroxyhexanoate
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Identifiers | |
299-28-5 ![]() |
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ChemSpider | 8932 ![]() |
ECHA InfoCard | 100.005.524 |
Jmol 3D model | Interactive image |
PubChem | 9290 |
UNII | SQE6VB453K ![]() |
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Properties | |
C12H22CaO14 | |
Molar mass | 430.373 g/mol |
Appearance | powder |
Odor | odorless |
Melting point | 120 °C (248 °F; 393 K) (decomposes) |
slowly soluble | |
Solubility | insoluble in alcohol and organic solvents |
Acidity (pKa) | 6-7 |
Pharmacology | |
A12AA03 (WHO) D11AX03 (WHO) | |
Hazards | |
NFPA 704 | |
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
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Infobox references | |
Calcium gluconate is a mineral supplement. It is manufactured by the neutralization of gluconic acid with lime or calcium carbonate.
It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.[1]
Contents
Medical uses[edit]
Hypocalcemia[edit]
10% calcium gluconate solution (given intravenously) is the form of calcium most widely used in the treatment of hypocalcemia. This form of calcium is not as well absorbed as calcium lactate,[2] and it only contains 0.93% (930 mg/dl) calcium ion (defined by 1 g weight solute dissolved in 100 ml solvent to make 1% solution w/v). Therefore, if the hypocalcaemia is acute and severe, calcium chloride is given instead.
Magnesium sulfate overdose[edit]
It is also used to counteract an overdose of Epsom Salts magnesium sulfate,[3] which is often administered to pregnant women in order to prophylactically prevent seizures (as in a patient experiencing preeclampsia). Magnesium sulfate is no longer given to pregnant women who are experiencing premature labor in order to slow or stop their contractions (other tocolytics are now used instead due to better efficacy and side effect profiles).[citation needed] Excess magnesium sulfate results in magnesium sulfate toxicity, which results in both respiratory depression and a loss of deep tendon reflexes (hyporeflexia). Calcium gluconate is the antidote for magnesium sulfate toxicity.
Hydrofluoric acid burns[edit]
Gel preparations of calcium gluconate are used to treat hydrofluoric acid burns.[4][5] This is because calcium gluconate reacts with hydrofluoric acid to form insoluble, non-toxic calcium fluoride.
Hyperkalemia[edit]
Calcium gluconate is used as a cardioprotective agent in hyperkalemia, with one alternative being use of calcium chloride.[6] Though it does not have an effect on potassium levels in the blood, it reduces the excitability of cardiomyocytes thus lowering the likelihood of developing cardiac arrhythmias.[7]
Black widow spider bites[edit]
Historically, IV calcium gluconate was used as an antidote for black widow spider envenomation, often in conjunction with muscle relaxants.[8] This therapy, however, has since been shown to be ineffective.[9][10]
Side effects[edit]
Calcium gluconate side effects include nausea, constipation, upset stomach. Rapid intravenous injections of calcium gluconate may cause hypercalcaemia, which can result in vasodilation, cardiac arrhythmias, decreased blood pressure, and bradycardia. Extravasation of calcium gluconate can lead to cellulitis. Intramuscular injections may lead to local necrosis and abscess formation.[11]
It is also reported that this form of calcium increases renal plasma flow, diuresis, natriuresis,[12][13] glomerular filtration rate,[14] and prostaglandin E2 and F1-alpha levels.[15]
Society and culture[edit]
Shortages of medical calcium gluconate were reported in November 2012 and November 2015 in the United States.[6][16]
References[edit]
- ^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
- ^ Spencer, H.; Scheck, J.; Lewin, I.; Samachson, J. (1966). "Comparative absorption of calcium from calcium gluconate and calcium lactate in man". The Journal of Nutrition. 89 (3): 283–292. PMID 4288031.
- ^ Omu AE, Al-Harmi J, Vedi HL, Mlechkova L, Sayed AF, Al-Ragum NS (2008). "Magnesium sulphate therapy in women with pre-eclampsia and eclampsia in Kuwait". Med Princ Pract. 17 (3): 227–32. doi:10.1159/000117797. PMID 18408392.
- ^ el Saadi MS, Hall AH, Hall PK, Riggs BS, Augenstein WL, Rumack BH (1989). "Hydrofluoric acid dermal exposure". Vet Hum Toxicol. 31 (3): 243–7. PMID 2741315.
- ^ Roblin I, Urban M, Flicoteau D, Martin C, Pradeau D (2006). "Topical treatment of experimental hydrofluoric acid skin burns by 2.5% calcium gluconate". J Burn Care Res. 27 (6): 889–94. doi:10.1097/01.BCR.0000245767.54278.09. PMID 17091088.
- ^ a b Faine; Miller (December 2013). "The Calcium Quandary". Emergency Physicians Monthly. Retrieved 20 November 2015.
- ^ Parham, W. A.; Mehdirad, A. A.; Biermann, K. M.; Fredman, C. S. (2006). "Hyperkalemia revisited". Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 33 (1): 40–47. PMC 1413606
. PMID 16572868.
- ^ Pestana, Carlos Dr. Pestana Surgery Notes Kaplan Medical 2013
- ^ Offerman, Steven (2011). "The Treatment of Black Widow Spider Envenomation with Antivenin Latrodectus Mactans: A Case Series". The Permanente Journal. 15: 76–81. PMC 3200105
. PMID 22058673.
- ^ Clark, Richard (July 1992). "Clinical presentation and treatment of black widow spider envenomation: A review of 163 cases". Annals of Emergency Medicine. 21: 782–787. doi:10.1016/S0196-0644(05)81021-2. Retrieved 2014-08-09.
- ^ Yui-Ming Lam; Hung-Fat Tse; Chu-Pak Lau (April 2001). "Continuous Calcium Chloride Infusion for Massive Nifedipine Overdose". Chest. 119 (4): 1280–1282. doi:10.1378/chest.119.4.1280. PMID 11296202.
- ^ Ruilope LM; Oliet A; Alcázar JM; Hernández E; Andrés A; Rodicio JL; García-Robles R; Martínez J; Lahera V; Romero JC. (December 1989). "Characterization of the renal effects of an intravenous calcium gluconate infusion in normotensive volunteers.". J Hypertens Suppl. 7 (6): 170. doi:10.1097/00004872-198900076-00081. PMID 2632708.
- ^ Bernardi M, Di Marco C, Trevisani F, Fornalè L, Andreone P, Cursaro C, Baraldini M, Ligabue A, Tamè MR, Gasbarrini G (July 1993). "Renal sodium retention during upright posture in preascitic cirrhosis.". Gastroenterology. 105 (1): 188–193. PMID 8514034.
- ^ Wong F, Massie D, Colman J, Dudley F (March 1993). "Glomerular hyperfiltration in patients with well-compensated alcoholic cirrhosis.". Gastroenterology. 104 (3): 884–900. PMID 8440439.
- ^ Lahera V, Fiksen-Olsen MJ, Romero JC (February 1990). "Stimulation of renin release by intrarenal calcium infusion.". Hypertension. 15 (2): 149–152. doi:10.1161/01.hyp.15.2_suppl.i149. PMID 2404858.
- ^ "FDA Drug Shortages". www.accessdata.fda.gov. Retrieved 2015-11-21.