Calcium gluconate

General characteristics. Structure:

Active agent: calcium a gluconate - 100 mg.

Excipients: succinic acid of 5 mg, hydroxide sodium solution of 0.1 M to pH 6.0-7.5, water for and to 1 ml.

Pharmacological properties:

Pharmacodynamics. Calcium drug, fills shortage of calcium ions, process of transfer of nervous impulses, necessary for implementation, reduction of skeletal and unstriated muscles, activity of a myocardium, formation of a bone tissue, a blood coagulation. At intravenous administration has moderate diuretic effect.

Pharmacokinetics. After parenteral administration drug with a blood flow is evenly distributed in all fabrics and bodies. In a blood plasma about 45% of calcium ions are in a complex with proteins. Passes through a placental barrier, gets to breast milk. It is brought out of an organism generally by kidneys.

Indications to use:

Treatment of the states caused by insufficiency of calcium: a gipokaltsiyemichesky tetany, a hypocalcemia owing to a hypoparathyrosis, rapid growth or pregnancy. Treatment of muscular spasms as auxiliary therapy of rickets, osteomalacy, a lead colica and overdose of magnesium of sulfate.
 
Decrease in permeability of capillaries at allergic states, not Werlhof's disease and an exudative dermatosis, for example, herpetiform dermatitis and pruritic rash owing to use of some medicines.

Route of administration and doses:

Intravenously slowly (within, at least, 3 minutes), intramusculary or kapelno. Hypodermic introduction is not allowed.
 
The adult enter on 5-10 ml of solution 100 mg/ml (10% of solution) daily, every other day or in 2 days (depending on the nature of a disease and a condition of the patient). If necessary about 3 once a day are allowed to enter.
 
Children intramusculary are not recommended to administer the drug because of possible development of a necrosis. To children 1 years - intravenously slowly or kapelno, depending on age are more senior, than 2 - 2, 5 ml of solution of 100 mg/ml (10% of solution).

To children 1 years no more than 200 mg (no more than 2 ml) are younger.
 
Solution before introduction is warmed up to body temperature.
 
The syringe for administration of calcium of a gluconate should not contain the ethanol remains. Children intramusculary are not recommended to administer the drug because of possible development of a necrosis.

Features of use:

Too bystry intravenous administration promotes emergence of undesirable reactions.
 
Ekstravation and hypodermic introduction washes to lead to local reactions.
 
At long administration of drugs of high doses of drugs of calcium it is necessary to control the maintenance of calcium ions in plasma and urine, especially at children.
 
Or with nefrourolitiazy in the anamnesis appointment has to be carried out by the patient with an insignificant hypercalcuria, decrease in glomerular filtering under control of calcium in urine. Plentiful drink is recommended to the patients inclined to formation of concrements in urinary tract.
 
It is recommended to avoid use of high doses of vitamin D.

Side effects:

At intravenous administration - nausea, vomiting, reddening, perspiration, a lowering of arterial pressure, a collapse, a cardiac standstill. At the patients applying cardiac glycosides development of arrhythmias is possible.
 
In certain cases allergic reactions.
 
Erubescence, burning and pain at an intravenous injection can be a sign of accidental introduction to surrounding fabrics that can lead to a necrosis of fabrics.
 
 
At an ekstravazation, hypodermic introduction can lead to local reactions, including reddening, hypostasis, consolidation and calcification of soft tissues. Local reactions are reversible, in certain cases - a necrosis of soft tissues with the subsequent scarring.

Interaction with other medicines:

Pharmaceutical it is incompatible with carbonates, salicylates, sulfates (forms insoluble or almost insoluble salts of calcium).
 
Forms insoluble complexes with antibiotics of a tetracycline row (reduces antibacterial effect).
 
Reduces effect of blockers of "slow" calcium channels.
 
At simultaneous use with quinidine delay of intra ventricular conductivity and increase in toxicity of quinidine is possible.
 
Slows down absorption of tetracyclines, digoxin, the peroral drugs Fe (the interval between their receptions has to be not less than 2 h).
 
At a combination to thiazide diuretics can strengthen a hypercalcemia. Reduces effect of a calcitonin at a hypercalcemia.
 
Reduces bioavailability of Phenytoinum.

Contraindications:

Individual intolerance of components of drug. Hypersensitivity, hypercalcemia, hypercalcuria, нефроуролитиаз, heavy acute renal failure, sarcoidosis, intoxication cardiac glycosides, simultaneous treatment by cardiac glycosides.
 
With care. Dehydration, electrolytic disturbances, diarrhea, sprue, calcic нефроуролитиаз, insignificant hypercalcuria, moderate chronic renal failure, chronic insufficiency of a krovoobrazeniye, widespread atherosclerosis, hypercoagulation, children's age.

Overdose:

Symptoms: nausea, vomiting, diarrhea. Undesirable reactions depend on rate of administering, causing "inflows", perspiration, arrhythmia, a lowering of arterial pressure and a collapse.
 
Treatment: symptomatic.

Storage conditions:

To store in the place protected from light at a temperature from 15 °C to 20 °C. To store in the place, unavailable to children.

Issue conditions:

According to the recipe

Packaging:

Solution for intravenous and intramuscular administration of 100 mg/ml in ampoules on 5 ml.

5 ampoules in a blister strip packaging from a film polyvinyl chloride.

1 or 2 blister strip packagings together with the application instruction and the scarificator ampoule in a cardboard pack.

5 or 10 ampoules together with the application instruction and the scarificator ampoule in a cardboard pack with a corrugated insert.

When packaging ampoules with a point or a ring of a break the scarificator ampoule is not put.