University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

112

Pages:

1
Author:

Mariam A.

Treatment of Hypocalcemia Overview: Hypocalcemia, characterized by low serum calcium levels, can result from various conditions, including vitamin D deficiency, chronic kidney disease, hypoparathyroidism, and acute pancreatitis. It can lead to neuromuscular irritability, tetany, seizures, and cardiac issues if not promptly addressed. Acute Hypocalcemia:   Presentation: Acute hypocalcemia presents with symptoms like paresthesia, muscle cramps, carpopedal spasms, laryngospasm, seizures, and prolonged QT interval on ECG. Management: o Intravenous Calcium: For severe symptoms, administer intravenous calcium gluconate or calcium chloride. Calcium gluconate is preferred due to its lower risk of tissue necrosis if extravasation occurs. The initial dose is usually 10-20 mL of 10% calcium gluconate (equivalent to 90-180 mg of elemental calcium) infused slowly over 10-20 minutes. o Continuous Infusion: Following the bolus, a continuous infusion of calcium gluconate may be necessary. This is typically 0.5-2 mg/kg/hr of elemental calcium. o Magnesium Repletion: If hypomagnesemia is present, magnesium repletion is crucial as it can impair PTH secretion and function. o Monitoring: Continuous cardiac monitoring and frequent serum calcium level checks are essential during treatment. Chronic Hypocalcemia:   Etiology: Chronic conditions like hypoparathyroidism, vitamin D deficiency, and renal failure are common causes. Management: o Oral Calcium Supplements: Calcium carbonate or calcium citrate is used. The typical dose ranges from 1-3 grams of elemental calcium daily, divided into multiple doses to improve absorption. o Vitamin D Supplementation: Calcitriol (1,25-dihydroxyvitamin D) is often used in hypoparathyroidism and chronic kidney disease to enhance calcium absorption. The typical dose is 0.25-2 µg daily. In vitamin D deficiency, ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) is administered. o Diet and Lifestyle: Ensuring adequate dietary intake of calcium and vitamin D, and encouraging exposure to sunlight. o Monitoring: Regular monitoring of serum calcium, phosphorus, magnesium, and renal function is essential to adjust therapy and prevent complications.