Hypocalcemia medical therapy: Difference between revisions
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===Contraindicated medications=== | ===Contraindicated medications=== | ||
Revision as of 18:58, 10 July 2018
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Hypocalcemia Microchapters |
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Hypocalcemia medical therapy On the Web |
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Risk calculators and risk factors for Hypocalcemia medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Cause, severity and the presence of symptoms decide the treatment of hypocalcemia. In mild to moderate cases hypocalcemia can be treated by giving oral calcium and vitamin D supplements but in severe cases intravenous (IV) calcium gluconate is preferred. Most of the hypocalcemic cases are mild and require only supportive treatment and laboratory evaluation.
Medical Therapy
- Pharmacologic medical therapies for hypocalcemia include calcium, vitamin D , calcium gluconate[1][2]
- Patients who are presenting with asymptomatic hypocalcemia symptoms it is important to repeat the levels of ionized calcium and confirm it.
THERAPEUTIC APPROACH
- Patients who are presenting with hypocalcemia we recommend intravenous (IV) calcium especially who are showing the following features[3]
- Patients who have prolonged QT interval.
- Patients who are having serum corrected calcium to ≤7.5 mg/dL.
- Patients who are positive for clinical symptoms like carpopedal spasm, tetany, seizures.
- Patients who are presenting with milder symptoms of neuromuscular irritability like paresthesias and corrected calcium levels more than 7.5 mg/dL treating with oral calcium and vitamin D supplements is of first choice.
- Patients with milder hypocalcemia who are on the oral supplements and shows no sign of improvement the next best best step in treating would be switching to IV calcium.
- And patients who are requiring intravenous (IV) repletion should be admitted.
- Preferred regimen (1): Elemental calcium 1-3 g/d.
Severe Hypocalcemia
- IV calcium is recommended for patients who shows symptoms of severe hypocalcemia like the following
- Carpopedal spasm
- Tetany
- Seizures
- QT interval prolongation
Contraindicated medications
Hypocalcemia is considered an absolute contraindication to the use of the following medications:
References
- ↑ Cooper MS, Gittoes NJ (June 2008). "Diagnosis and management of hypocalcaemia". BMJ. 336 (7656): 1298–302. doi:10.1136/bmj.39582.589433.BE. PMC 2413335. PMID 18535072.
- ↑ Carroll R, Matfin G (February 2010). "Endocrine and metabolic emergencies: hypocalcaemia". Ther Adv Endocrinol Metab. 1 (1): 29–33. doi:10.1177/2042018810366494. PMC 3474611. PMID 23148147.
- ↑ Carroll R, Matfin G (February 2010). "Endocrine and metabolic emergencies: hypocalcaemia". Ther Adv Endocrinol Metab. 1 (1): 29–33. doi:10.1177/2042018810366494. PMC 3474611. PMID 23148147.