Normally, the concentration of total calcium in the blood serum is 2.25-2.75 mmol / l or 4.45-5.5 cq / l. Therapy with calcium gluconate is aimed at restoring the normal concentration of calcium in the blood plasma. Solutions containing calcium should be administered slowly in order to minimize peripheral vasodilation and inhibition of cardiac activity.
The preparation is heated to the body temperature before administration. The drug is injected deeply intramuscularly or intravenously slowly (for 2-3 minutes), or drip, to exclude the possibility of local irritation or necrosis in case of getting the drug into the perivascular tissue. Intravenous injections should be carried out under close monitoring of the heart rate and electrocardiogram, because with too fast administration of calcium gluconate, bradycardia with vasodilation and arrhythmias can occur.
With intravenous administration, a feeling of heat can be felt throughout the body, which quickly passes.
Because of the risk of local irritation, intramuscular injections should be performed only in the event that,if intravenous injection is not possible. Intramuscular injections must be performed deep enough in the muscle, preferably in the gluteal region. For patients suffering from obesity, a longer needle should be chosen for safe insertion into the muscle, rather than in fatty tissue. If repeated injections are required, the injection site should be changed each time.
During treatment, it is necessary to carefully monitor the concentration of calcium in the blood plasma, when administered in high doses - in addition to control the rate of calcium excretion in the urine.
Adults: deep intramuscularly, intravenously slowly (for 2-3 min) or drip 5-10 ml of 100 mg / ml (10% solution) daily, every other day or 2 days (depending on the nature of the disease and the clinical condition of the patient). The subsequent doses are determined in accordance with the concentration of calcium in the blood serum.
Children under 18 years: the dose and mode of administration depend on the degree of development of hypocalcemia, the nature and severity of the symptoms.
Children, depending on the age, the drug at a concentration of 100 mg / ml (10% solution) is administered in the following doses: up to 6 months - 0.1-1 ml; 7-12 months - 1-1.5 ml; 1-3 years -
1.5-2 ml; 4-6 years - 2-2.5 ml; 7-14 years - 3.5 ml; over 14 years - doses for adults.Children should not inject the drug intramuscularly because of the possible development of necrosis. It is recommended only slow intravenous injection or intravenous infusion after dilution, in order to achieve sufficiently low rates of administration and to exclude the possibility of local irritation or necrosis with accidental ingestion of the drug into the perivascular tissue.
For intravenous infusion, the drug is diluted 1:10 to 10 mg / ml with the following infusion solutions: 0.9% sodium chloride solution or 5% glucose solution. The rate of intravenous administration should not exceed 50 mg of calcium gluconate per minute. Dilution should be carried out under aseptic conditions.
Elderly patients: data indicating an adverse tolerance of calcium gluconate to elderly patients are not available, however, age-related changes, such as renal dysfunction and metabolic slowdown, may require a dose reduction.
The procedure for working with a polymer ampoule:
- Take an ampoule and shake it, holding it by the neck.
- Rotate the valves and turn off the valve.
- Through the formed hole, immediately connect the syringe loer with the ampoule.
- Type the contents of the ampoule into the syringe.
- Put the needle on the syringe.