Calcium hypocalcemia treatment using

The calcium salts are used in the emergency treatment of hypocalcemia, in hyperkalemia, in hypermagnesemia, and in hyperphosphatemia in end-stage renal failure. In addition, they are used in prevention of osteoporosis (see also Figure 105). 

Because of its toxicity, plicamycin (mithramycin) is not the drug of first choice for the treatment of hypercalcemia. However, when other forms of therapy fail, 25-50 mcg/kg given intravenously usually lowers serum calcium substantially within 24-48 hours. This effect can last several days. This dose can be repeated as necessary. The most dangerous toxic effect is sudden thrombocytopenia followed by hemorrhage. Hepatic and renal toxicity can also occur. Hypocalcemia, nausea, and vomiting may limit therapy. Use of this drug must be accompanied by careful monitoring of platelet counts, liver and kidney function, and serum calcium levels. 

Giving intravenous phosphate is probably the fastest and surest way to reduce serum calcium, but it is a hazardous procedure if not done properly. Intravenous phosphate should be used only after other methods of treatment (bisphosphonates, calcitonin, and saline diuresis) have failed to control symptomatic hypercalcemia. Phosphate must be given slowly (50 mmol or 1.5 g elemental phosphorus over 6-8 hours) and the patient switched to oral phosphate (1-2 g/d elemental phosphorus, as one of the salts indicated below) as soon as symptoms of hypercalcemia have cleared. The risks of intravenous phosphate therapy include sudden hypocalcemia, ectopic calcification, acute renal failure, and... 

Methods for the depolymerization of dextran to uniform fractions of lower molecular weight have led to the use of two dextran fractions that are suitable for parenteral administration.13,30 In the United States, a dextran fraction of MW 70,000 is used as a blood-volume expander. Clinical dextran is used to restore blood volume in the treatment of patients who have either lost considerable amounts of blood or are in shock. A dextran fraction of MW 40,000 is used to improve the flow in capillaries, to prevent or treat vascular occlusion, and to perfuse organs artifically. B-512(F) dextran is completely metabolized141 in man when fractions are administered parentally. Various dextran fractions have been used to prepare numerous derivatives,29 such as the sulfates, and 0-(2-diethylaminoethyl) (DEAE)-dextran, and complexes with various metals. Dextran sulfates have anticoagulant,340 antilipemic,340 and anti-ulcer341 activity. A soluble, iron-dextran complex342 of MW 5000 is used to alleviate iron-deficiency anemia, and a calcium complex332 alleviates hypocalcemia of cattle. 

Cinacalcet is available in 30-, 60-, and 90-mg tablets. Optimal doses have not been defined. The recommended starting dose for treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis is 30 mg once daily, with a maximum of 180 mg/day. For treatment of parathyroid carcinoma, a starting dose of 30 mg twice daily is recommended, with a maximum of 90 mg four times daily. The starting dose is titrated upward every 2 to 4 weeks to maintain the PTH level between 150 and 300 pg/mL (secondary hyperparathyroidism) or to normalize serum calcium (parathyroid carcinoma). The principal adverse event with cinacalcet is hypocalcemia. Thus, the drug should not be used if the initial serum calcium concentration is less than 8.4 mg/dL serum calcium and phosphorus concentrations should be measured within 1 week, and PTH should be measured within 4 weeks after initiating therapy or after changing dosage. 

Clinical use The primary use of EDTA is in the treatment of lead poisoning. Because the agent is very polar, it is given parenterally and it does not enter cells. To prevent dangerous hypocalcemia, EDTA is usually given as the calcium disodium salt. 

Uses Calcium source, dietary supplement for pharmaceuticals, orals, injections, syrups, low-birth-wt. infants, treatment of hypocalcemia, calcium deficiency, hypoparathyroidism, osteoporosis, rickets Regulatory USP compliance Manuf./Distrib. Calcium Group Shan Par Ind. http //www.shanpar. com... 

Most treatments in ruminants require the addition of calcium to the magnesium salts to correct the hypocalcemia that is commonly observed in these animals. Magnesium enemas have also been used [86]. Injectable or rectally administered magnesium is then followed by the use of oral magnesium preparations until the Mg levels have stabilized and the underlying cause has been corrected. 

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