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10% calcium gluconate solution (given intravenously) is the form of calcium most widely used in the treatment of hypocalcemia. This form of calcium is not as well absorbed as calcium lactate, and it only contains 0.93% (930 mg/100ml) calcium ion (defined by 1gm weight solute dissolved in 100ml solvent to make 1% solution w/v). Therefore, if the hypocalcaemia is acute and severe, calcium chloride is given instead.
It is also used to counteract an overdose of magnesium sulfate, which is often administered to pregnant women in order to prophylactically prevent seizures (as in patient experiencing preeclampsia). Magnesium sulfate is also given to pregnant women who are experiencing premature labor in order to slow or stop their contractions. Excess magnesium sulfate results in magnesium sulfate toxicity, which results in both respiratory depression and a loss of deep tendon reflexes (hyporeflexia). Calcium gluconate is the antidote for magnesium sulfate toxicity.
Calcium gluconate is also used as a cardioprotective agent in hyperkalemia. Though it does not have an effect on potassium levels in the blood, it reduces the excitability of cardiomyocytes thus lowering the likelihood of developing cardiac arrhythmias.
Calcium gluconate side effects include nausea, constipation, upset stomach. Rapid intravenous injections of calcium gluconate may cause hypercalcaemia, which can result in vasodilation,cardiac arrhythmias, decreased blood pressure, and bradycardia. Extravasation of calcium gluconate can lead to cellulitis. Intramuscular injections may lead to local necrosis and abscess formation.