Calcium Gluconate
Hyperkalemia (cardiac membrane stabilization), Calcium channel blocker overdose, Hydrofluoric acid burns, Magnesium toxicity
Indications
- Hyperkalemia (cardiac membrane stabilization)
- Calcium channel blocker overdose
- Hydrofluoric acid burns
- Magnesium toxicity
Adult dosing
- hyperkalemia: dose: 1; unit: g (10mL of 10%) IV over 2-3 min; route: IV; fixed: true; ccb overdose: dose: 3; maxDose: 6; unit: g IV bolus; route: IV; fixed: true; hf burn: dose: 2.5; unit: % gel topical; route: Topical; fixed: true
Pediatric dosing
- hyperkalemia: dose: 60; unit: mg/kg; maxDose: 3000; maxDoseAbsolute: true; route: IV over 5 min; weightBased: true; pedNote: 60-100mg/kg; 0.5mL/kg of 10% solution
Contraindications
- Digoxin toxicity (relative — may worsen arrhythmias)
Clinical pearls
- Stabilizes cardiac membrane but does NOT lower potassium — must also give insulin/dextrose, bicarb, albuterol
- Can repeat dose in 5-10 min if ECG changes persist
- AVOID in digoxin toxicity — "stone heart" phenomenon; use digoxin Fab instead
- Calcium chloride (CaCl) has 3x more elemental calcium but requires central line
Source and review
- AHA ACLS Guidelines; Goldfrank's Toxicologic Emergencies. Last reviewed: 2024-11-01