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10% calcium gluconate solution (given intravenously) is the form of calcium most widely used in the treatment of low blood calcium.This form of calcium is not as well absorbed as calcium lactate, [12] and it only contains 0.93% (93 mg/dL) calcium ion (defined by 1 g weight solute in 100 mL of solution to make 1% solution w/v).
The intravenous formulations of calcium include calcium chloride and calcium gluconate. [1] The forms that are taken by mouth include calcium acetate, calcium carbonate, calcium citrate, calcium gluconate, calcium lactate, and calcium phosphate. [1] The absorption of calcium from most food and commonly used dietary supplements is very similar. [27]
Calcium lactate gluconate, also known as GLOCAL, is a soluble salt of calcium, lactic acid and gluconic acid used in effervescent calcium tablets. [1] Its chemical formula is Ca 5 (C 3 H 5 O 3) 6 ·(C 6 H 11 O 7) 4 ·2H 2 O. It was first developed by Sandoz, Switzerland.
Intravenous calcium gluconate (or calcium chloride if a central line is available) and atropine are first-line therapies. If the time of the overdose is known and presentation is within two hours of ingestion , activated charcoal , gastric lavage , and polyethylene glycol may be used to decontaminate the gut.
Gluconate is also an electrolyte present in certain solutions, such as "plasmalyte a", used for intravenous fluid resuscitation. [20] Quinine gluconate is a salt of gluconic acid and quinine, which is used for intramuscular injection in the treatment of malaria. Ferrous gluconate injections have been proposed in the past to treat anemia. [21]
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Medications to treat the toxic effects include: intravenous fluids, calcium gluconate, glucagon, high dose insulin, vasopressors and lipid emulsion. [1] [2] Extracorporeal membrane oxygenation may also be an option. [1] More than ten thousand cases of calcium channel blocker toxicity were reported in the United States in 2010. [2]
The signs and symptoms of milk-alkali syndrome can develop after only a few days and up to several months following the initial ingestion of absorbable calcium and alkali. [3] However, the severity of signs and symptoms of milk-alkali syndrome is largely dependent upon the duration and quantity of calcium and alkali ingested. [4]