Calcium is a macronutrient that is naturally present in the body, mainly in bones and teeth. Normal blood calcium levels are important to maintain, as both low (hypocalcemia) and high (hypercalcemia) levels can be dangerous. Calcium supplements come in various forms including tablets, capsules, and injectable solutions. Intravenous calcium gluconate is used in emergencies and ICU settings to rapidly increase calcium levels. While calcium has many important uses, it also has potential side effects that depend on the specific form administered. Proper dosing and administration are necessary to safely treat conditions like hypocalcemia while avoiding issues from excess calcium.

1. CALCIUM
Introduction:
Calcium is naturally present in our body. Calcium is a
macronutrient. Calcium is generally present in bones and teeth
of the human. Normal level of calcium in blood is 8.5 – 10.5
mg/dl.
Below these normal level is known as hypocalcemia.
Above these level are known as hypercalcemia. Both are
dangerous.
Calcium in medicine:
Brand name:
Citracal + D, Os-Cal, Oyster Shell + D are the some brand
name of calcium drugs.

2. Root of administration :
Calcium Gluconate should be
administered intravenously either directly or by
infusion.
Calcium Gluconate is a mineral
supplement of calcium.
Some times calcium can be given in form of tablet. But in
emergency and in ICU it is given in form of IV.

3. Duration :
30 minutes to two hours . Calcium gluconate
may be administered at a rate not exceeding 200
mg/minute.
What happen if we give calcium gluconate as fast?
Rapid intravenous injections of calcium gluconate
may cause hypercalcaemia, which can result in
vasodilation, cardiac arrhythmias, decreased blood
pressure, and bradycardia
Dosage :
Injectable solution :
100mg/mL
Tablet :
50mg
500mg
650mg
Capsule :
500 mg

4. The above dosage is applicable for both adult and
pediatric.
Time of onset of action :
Medication Response type Duration of
action
Calcium gluconate rapid, immediate action. 30
to 120 minute.
Metabolism: Absorption requires Vitamin D.
Absorption is increased with acidic condition; thus,
administer 1-2 hr after meals.
Indication :
Hyperkalemia : High potassium level in blood.
It causes nausea, chest pain,
irregular heart beat, weakness.
Hypocalcemia : Low level of calcium in blood.
It causes abnormal heart rate ,
muscle spasms, Seizures.
Hypermagnesemia : High level of magnesium in
blood. It causes weakness, decreased
breathing rate, cardiac arrest.

5. Calcium channel blocker overdose : it causes slow
heart rate and low blood pressure. These are the
some of the indication of drug calcium.
Contraindication :
Hypophosphatemia : electrolyte disorder in
which there is a low level of phosphate in the blood
It causes muscle weaken, coma, death, bone become
weak, breathing difficulty.
Hyperphosphatemia : electrolyte disorder in
which there is an elevated level of phosphate in
the blood.
It causes tetany, joint pain, muscle cramps,
rash.
Hypothyroidism : Hypothyroidism’s
deficiency of thyroid hormones .
It causes dry skin, constipation, weight gain, slow
heart rate.
Hypercalcemia : High level of calcium in
blood.
It causes muscle weakness, nausea, weight loss,
mental confusion.

6. Uses of calcium :
*it is used In people who does not have normal
level of calcium in their body.
*it is used to treat a condition called
osteoporosis weak bones, rickets.
*calcium chloride injection is used to cardiac
resuscitation and treat insect bites and stings.
*calcium carbonate is used to treat kidney
failure.
*High intake of calcium through diet or tablet
can decrease the risk of cholestrol cancer.
*calcium is used to reduce the blood pressure.
*taking calcium in the form of tablet prevent
tooth loss.
*recent research proves that taking limited
amount calcium causes lower risk of heart
diseases.
*Taking calcium carbonate by mouth has an
antacid which is effective for indigestion.
Side effect :
Calcium gluconate _ Nausea, constipation,
stomach ulcers, vasodilation, cardiac

7. arrhythmias, decreased blood pressure,
bradycardia, local necrosis. Among these
calcium drugs calcium gluconate have a low
side effects.
Calcium chloride _ vomiting, temporary
redness of neck and face, excessive sweating,
numbness and tingling. It is an highly irritant
drug.
Calcium lactate _ increased urination, dry
mouth, increased thirst, decreased appetite.
Calcium carbonate _stomach pain,
belching, constipation, dry mouth, loss of
appetite.

8. pharmacodynamics :
Many enzymes require calcium ions as a
cofactor, those of the blood-clotting cascade being
notable examples. Extracellular calcium is also
important for maintaining the potential difference
across excitable cell membranes, as well as proper
bone formation.
Pharmacokinetics :
Metabolism _ calcium gluconate is better
tolerated through a peripheral IV. However, you

9. recall that calcium gluconate might possess a
slower onset of action because it requires hepatic
metabolism to release the elemental and active
form of calcium.
Excretion _Renal (20%) – The amount
excreted in the urine varies with degree of calcium
absorption and whether there is excessive bone
loss or failure of renal conservation. Fecal (80%) –
Consists mainly of nonabsorbed calcium, with only
a small amount of endogenous fecal calcium
excreted.

10. Thank you
....... By
M. B. Sarun