Grownup Therapeutics Handbook
Introduction
The reference vary for adjusted serum calcium is 2.2 – 2.6mmol/L. Acute hypocalcaemia could be life-threatening and will necessitate pressing therapy. In extreme circumstances intravenous calcium kinds the mainstay of preliminary remedy however it’s important to establish the underlying trigger and begin particular therapy as early as potential.
Signs of hypocalcaemia, similar to muscle cramps, paraesthesia, tetany and carpopedal spasm, sometimes develop when serum adjusted calcium falls beneath 1.9mmol/L. Nonetheless, this threshold varies and signs additionally rely on the speed of fall.
Evaluation / monitoring
Preliminary biochemical investigations:
A 12-lead ECG ought to be carried out as there’s a vital chance of QT prolongation and cardiac monitoring could also be required.
Monitor serum calcium concentrations repeatedly to evaluate response and evaluation therapy. Serum bone profile ought to be checked every day initially after which 3 times per week when steady. On discharge, advise the GP to test the serum bone profile each fortnight till concentrations are steady.
Drug remedy / therapy choices
Delicate Hypocalcaemia: serum adjusted calcium 1.9 – 2.2mmol/L and asymptomatic
Start oral calcium complement e.g. Calcichew Forte Chewable, 2 tablets twice a day* (unlicensed dose) and regulate to affected person’s particular person necessities.
*That is an unlicensed dose of Calcichew Forte Chewable tablets. Overview on discharge and if applicable prescribe the licensed dose (1 pill every day).
Extreme Hypocalcaemia: serum adjusted calcium <1.9mmol/L and/or symptomatic This can be a medical emergency. Administer calcium gluconate 10% IV as follows: Content material final up to date: March 2020 Web page final up to date: June 2020
– “calcium replacement”