hypocalcemia


Causes

Symptoms

  • mild: muscle cramps, tingling sensations
  • severe: seizure
  • long QT

Treatment

  • Usually do not need repletion unless ionized < 1.0. For hyperphosphatemia, repleting Ca can cause Ca-phos deposition and calciphylaxis.
  • Give caltritriol (vit D) to raise Ca.
    • Calcitriol suppresses PTH. Do not give if PTH too low (could cause bone disease). Give 0.25 mcg/day starting dose

Minor

  • oral calcium: calcium citrate or carbonate, aka tums
  • Calcitriol: activated vitamin D, necessary for Ca absorption

Severe

  • symptomatic, prolonged QTc, Ca < 7.5
  • IV calcium gluconate bolus followed by infusion
  • 10 g in 1L NS over 24 hours
  • start PO at same time
  • typically ordered by endocrine consult