Hypocalcemia medical therapy: Difference between revisions

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* And patients who are requiring intravenous (IV) repletion should be admitted.
* And patients who are requiring intravenous (IV) repletion should be admitted.
** Preferred regimen (1): Elemental calcium 1-3 g/d.  
** Preferred regimen (1): Elemental calcium 1-3 g/d.  
==== Severe Hypocalcemia ====
*


===Contraindicated medications===
===Contraindicated medications===

Revision as of 16:49, 10 July 2018

Hypocalcemia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]


Overview

Cause, severity and the presence of symptoms decide the treatment of hypocalcemia. In mild to moderate cases hypocalcemia can be treated by giving oral calcium and vitamin D supplements but in severe cases intravenous (IV) calcium gluconate is preferred. Most of the hypocalcemic cases are mild and require only supportive treatment and laboratory evaluation.

Medical Therapy

  • Pharmacologic medical therapies for hypocalcemia include calcium, vitamin D , calcium gluconate
  • Patients who are presenting with asymptomatic hypocalcemia symptoms it is important to repeat the levels of ionized calcium and confirm it.

THERAPEUTIC APPROACH 

  • Patients who are presenting with hypocalcemia we recommend intravenous (IV) calcium especially who are showing the following features
    • Patients who have prolonged QT interval.
    • Patients who are having serum corrected calcium to ≤7.5 mg/dL.
    • Patients who are positive for clinical symptoms like carpopedal spasm, tetany, seizures.
  • Patients who are presenting with milder symptoms of neuromuscular irritability like paresthesias and corrected calcium levels more than 7.5 mg/dL treating with oral calcium and vitamin D supplements is of first choice.
  • Patients with milder hypocalcemia who are on the oral supplements and shows no sign of improvement the next best best step in treating would be switching to IV calcium.
  • And patients who are requiring intravenous (IV) repletion should be admitted.
    • Preferred regimen (1): Elemental calcium 1-3 g/d.

Severe Hypocalcemia

Contraindicated medications

Hypocalcemia is considered an absolute contraindication to the use of the following medications:

References

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