Nephrology

547 INTRAVENOUS CALCIUM MAGNESIUM

  • CALCIUM GLUCONATE

    Supplied as 10% solution, containing 89 mg Ca++  /10 ml ampoule (or 2.25 mmol Ca++ /10 ml ampoule)

    Administration    

    • Rapid IV injection
    • Give over 3-5 minutes, checking heart rate each minute
    • Slow IV infusion
    • Give over 3 hours.

    IV Additive  

    Dose

    Rapid IV injection for symptomatic hypocalcaemia    0.5 ml / kg/ dose

    Slow IV infusion    500 mg Ca++/m2  over 3 hours (55 ml of 10% calcium gluconate/m2)

    IV Additive    Up to 10 mmol Ca++/l may be added to IV fluids. Symptomatic hypocalcaemia in neonates may be treated with intravenous calcium infusion at a rate of 20 -24 ml of 10% calcium gluconate per day (about 1 ml/h).

    Check serum [Ca++] response to IV infusion.

    MAGNESIUM

    Supplied as 50% Magnesium Sulphate (MgSO4.7H2O) = 2 mmol Mg++/ml 

    Molar Magnesium Chloride  (480 mg/5ml) = 1 mmol Mg++/ml

    Administration   

    Slow IV infusion

    Dose

    6 -12 mmol/m2   (0.2 - 0.4 mmol/kg) over 12-24 hours for symptomatic hypomagnesaemia

    50% MgSO4   may also be diluted to 20% and given intramuscularly (0.2 mMol/kg)

    PHOSPHATE

    Supplied as Potassium Hydrogen Phosphate (K2HPO4/KH2PO4) 1 mMol/ml

    Administration  

    Slow IV infusion

    Dose

    Up to 10 mmol phosphate/litre may be added to IV fluid

    300-500 mg (10-17 mmol) per m2  per day is required for normal intravenous nutrition of children over 5 years of age. Younger children may be given greater amounts per m2