CALCIUM PREPARATIONS

1. Therapeutic Effects
   1. Reverses overdose with magnesium sulfate or calcium channel blockers. Relieves some types of muscle spasms. Increases the strength of myocardial contractions.

2. Indications
   1. To oppose the actions of potassium in HYPERKALEMIA.
   2. As an antidote to MAGNESIUM.
   3. To relieve muscle spasm and pain from the bites of BLACK WIDOW SPIDER, SCORPION, and PORTUGUESE MAN-O-WAR.

3. Contraindications
   1. Should be used with extreme caution and in reduced dosage in patients taking digitalis.

4. Side Effects
   1. When given to a patient who has been taking digitalis or when given too rapidly, calcium can cause sudden death from ventricular fibrillation.
   2. Rapid IV administration may cause metallic or chalky taste, paresthesias, vasodilation, hypotension, and a feeling that a "wave of heat" is passing through the body.

5. How Supplied
   1. Calcium chloride: 10 ml of a 10% solution is prefilled syringes (13.6 mEq Ca++)
   2. Calcium gluconate: 10 ml of a 10% solution (4.8 mEq Ca++)

6. Administration and Dosage
   1. Calcium preparations are given as a slow intravenous injection.
   2. For severe muscle pain after black widow spider bite: calcium gluconate, 10 ml of a 10% solution IV.
   3. For Magnesium sulfate overdose: calcium gluconate, 10 ml of a 10% solution slowly IV.

7. Incompatibility
   1. Should not be given in the same infusion with sodium bicarbonate, since calcium chloride will combine with sodium bicarbonate to form an insoluable prcipitate (calcium carbonate, i.e., chalk).