It is closely related to calcium borogluconate, which is commonly used in veterinary medicine owing to its higher solubility.[9] It is used for intravenous administration of calcium, notably in ruminants.[10]
Calcium gluconate is produced commercially through three main methods. These three methods are: chemical oxidation of glucose with ahypochlorite solution, electrolytic oxidation of a glucose solution containing a known value ofbromide, and afermentation process where specificmicroorganisms are grown in a medium containing glucose and various other ingredients.[11]
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10% calcium gluconate solution (givenintravenously) is the form of calcium most widely used in the treatment oflow blood calcium. This form of calcium is not as well absorbed ascalcium lactate,[12] and it only contains 0.93% (93 mg/dL) calcium ion (defined by 1 g weight solute in 100 mL of solution to make 1% solutionw/v). Therefore, if the hypocalcemia is acute and severe,calcium chloride is given instead.
Calcium gluconate is used as a cardioprotective agent in people withhigh blood potassium levels, with one alternative being the use of calcium chloride.[13] It is recommended when the potassium levels are high (>6.5 mmol/L) or when theelectrocardiogram (ECG) shows changes due to high blood potassium.[2]
Though it does not have an effect on potassium levels in the blood, it reduces the excitability ofcardiomyocytes, thereby lowering the likelihood ofcardiac arrhythmias.[14]
It is also used to counteract an overdose of Epsom saltsmagnesium sulfate,[15] which is often administered to pregnant women in order to prophylactically prevent seizures (as in a patient experiencingpreeclampsia). Magnesium sulfate is no longer given to pregnant women who are experiencingpremature labor in order to slow or stop their contractions (othertocolytics are now used instead due to better efficacy and side effect profiles).[citation needed] Excess magnesium sulfate results in magnesium sulfate toxicity, which results in bothrespiratory depression and a loss ofdeep tendon reflexes (hyporeflexia).
Gel preparations of calcium gluconate are used to treathydrofluoric acid burns.[16][17] The calcium gluconate reacts with hydrofluoric acid to form insoluble, non-toxiccalcium fluoride. In addition to a 2.5% calcium gluconate gel being applied directly to thechemical burn, the victim should be provided with oral or injected calcium supplementation because the fluoride ion (F−) precipitatesserum calcium and can thus prompthypocalcemia.[18]
^World Health Organization (2019).World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization.hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^Constable, P (November 2003). "Fluid and electrolyte therapy in ruminants".Veterinary Clinics of North America: Food Animal Practice.19 (3):557–597.doi:10.1016/S0749-0720(03)00054-9.PMID14608802.
^Spencer H, Scheck J, Lewin I, Samachson J (July 1966). "Comparative absorption of calcium from calcium gluconate and calcium lactate in man".The Journal of Nutrition.89 (3):283–292.doi:10.1093/jn/89.3.283.PMID4288031.
^abMiller D, Faine B (December 2013)."The Calcium Quandary".Emergency Physicians Monthly.Archived from the original on 21 November 2015. Retrieved20 November 2015.
^Omu AE, Al-Harmi J, Vedi HL, Mlechkova L, Sayed AF, Al-Ragum NS (2008). "Magnesium sulphate therapy in women with pre-eclampsia and eclampsia in Kuwait".Medical Principles and Practice.17 (3):227–232.doi:10.1159/000117797.PMID18408392.S2CID3079436.
^el Saadi MS, Hall AH, Hall PK, Riggs BS, Augenstein WL, Rumack BH (June 1989). "Hydrofluoric acid dermal exposure".Veterinary and Human Toxicology.31 (3):243–247.PMID2741315.
^Roblin I, Urban M, Flicoteau D, Martin C, Pradeau D (2006). "Topical treatment of experimental hydrofluoric acid skin burns by 2.5% calcium gluconate".Journal of Burn Care & Research.27 (6):889–894.doi:10.1097/01.BCR.0000245767.54278.09.PMID17091088.S2CID3691306.
^Urden LD (2014).Critical Care Nursing : Diagnosis and Management (7th ed.). St. Louis, Mo.: Elsevier/Mosby. p. 936.ISBN978-0-323-09178-7.OCLC830669119.
^Lam YM, Tse HF, Lau CP (April 2001). "Continuous calcium chloride infusion for massive nifedipine overdose".Chest.119 (4):1280–1282.doi:10.1378/chest.119.4.1280.PMID11296202.
^Ruilope LM, Oliet A, Alcázar JM, Hernández E, Andrés A, Rodicio JL, et al. (December 1989). "Characterization of the renal effects of an intravenous calcium gluconate infusion in normotensive volunteers".Journal of Hypertension Supplement.7 (6):S170 –S171.doi:10.1097/00004872-198900076-00081.PMID2632708.
^Bernardi M, Di Marco C, Trevisani F, Fornalè L, Andreone P, Cursaro C, et al. (July 1993). "Renal sodium retention during upright posture in preascitic cirrhosis".Gastroenterology.105 (1):188–193.doi:10.1016/0016-5085(93)90025-8.PMID8514034.
^Wong F, Massie D, Colman J, Dudley F (March 1993). "Glomerular hyperfiltration in patients with well-compensated alcoholic cirrhosis".Gastroenterology.104 (3):884–889.doi:10.1016/0016-5085(93)91026-e.PMID8440439.
^Clark RF, Wethern-Kestner S, Vance MV, Gerkin R (July 1992). "Clinical presentation and treatment of black widow spider envenomation: a review of 163 cases".Annals of Emergency Medicine.21 (7):782–787.doi:10.1016/S0196-0644(05)81021-2.PMID1351707.
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