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You are here: Home / 09. Medical/Surgical / electrolyte-disorders / Calcium Disorders

Calcium Disorders

July 14, 2011 by CrashMaster

60% of body weight is water.  2/3 intracellular, 1/3 extracellular.  3/4 is interstitial, 1/4 plasma.

Ca=Ca + .8(4-ALB)

Albumin-adjusted calcium not suitable for diagnosis of calcium abnormalities, get an ionized calcium (Crit Care Med 31(5):1389, May 2003)

 

Ccalc = Cobs/(0.25ALB + 0.1)

Ical to SI = mg/dl x 0.5872= mmol/L

Hypocalcemia

hypo-pth, Vit D deficiency, PTH resistance, Calcium chelation

May see after large transfusion or contrast media

Chvostek-tapping facial nerve causes twitching (Insensitive and non-specific Neurology March 12, 2013 vol. 80 no. 11 1067)

Trousseau’s-carpal spasm after 3 min of BP Cuff at 20 over systolic

QT prolongation

May see stridor

1st step should be to get ionized Ca

1 amp of CaCl=270 mg Ca, CaGluc=93 mg of Ca

 

Rx for Severe

0.5 mcg of ?

Calc Gluconate

Cal Carbonate ?500

Ical > 4

Hypercalcemia

HyperPTH, Malignancy Sarcoid, Vit D, or Thiazides

Parathyroid

Addison’s

Multiple Myeloma

Paget’s

Sarcoid

Cancer (Usually Squamous Lung CA)

Hyperthryoid

Milk Alkali Syndrome

Immobilization

D-Vitamin D

Thiazide Diuretics

Fluids, Furosemide, Mithramycin (lowers Ca by decreasing bone turnover, 25 mcg/kg infused in D5W over 4-8 hours) Calcitonin, Biphosponates, Dialysis, Steroids

Neurology March 12, 2013 vol. 80 no. 11 1067

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