| 词条 | Calcium gluconate |
| 释义 |
| drug_name = | INN = | type = | IUPAC_name = calcium (2R,3S,4R,5R)- 2,3,4,5,6-pentahydroxyhexanoate | image = Calcium gluconate.svg | width = | alt = | image2 = Calcium gluconate ball-and-stick.png | width2 = | alt2 = | imageL = | widthL = | altL = | imageR = | widthR = | altR = | caption = | pronounce = KAL see um GLUE koe nate | tradename = | Drugs.com = {{Drugs.com|monograph|calcium-salts}} | MedlinePlus = | licence_EU = | licence_US = | DailyMedID = | pregnancy_AU = | pregnancy_AU_comment = | pregnancy_US = A | pregnancy_US_comment = and C | pregnancy_category= | dependency_liability = | addiction_liability = | routes_of_administration = by mouth, IV, topical | legal_AU = | legal_AU_comment = | legal_CA = | legal_CA_comment = | legal_DE = | legal_DE_comment = | legal_NZ = | legal_NZ_comment = | legal_UK = | legal_UK_comment = | legal_US = | legal_US_comment = | legal_UN = | legal_UN_comment = | legal_status = | bioavailability = | protein_bound = | metabolism = | metabolites = | onset = | elimination_half-life = | duration_of_action = | excretion = | CAS_number = 299-28-5 | CAS_supplemental = | class = | ATCvet = | ATC_prefix = A12 | ATC_suffix = AA03 | ATC_supplemental = {{ATC|D11|AX03}} | PubChem = 9290 | PubChemSubstance = | IUPHAR_ligand = | DrugBank = | ChemSpiderID = 8932 | UNII = SQE6VB453K | KEGG = | ChEBI = | ChEMBL = | NIAID_ChemDB = | synonyms = | chemical_formula = | C=12 | H=22 | Ag= | Al= | As= | Au= | B= | Bi= | Br= | Ca=1 | Cl= | Co= | F= | Fe= | Gd= | I= | K= | Li= | Mg= | Mn= | N= | Na= | O=14 | P= | Pt= | S= | Sb= | Se= | Sr= | Tc= | Zn= | charge= | molecular_weight = 430.373 | SMILES = [Ca+2].[O-]C(=O)[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO.[O-]C(=O)[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO | Jmol = | StdInChI = 1S/2C6H12O7.Ca/c2*7-1-2(8)3(9)4(10)5(11)6(12)13;/h2*2-5,7-11H,1H2,(H,12,13);/q;;+2/p-2/t2*2-,3-,4+,5-;/m11./s1 | StdInChI_Ref = {{stdinchicite|correct|chemspider}} | StdInChIKey = NEEHYRZPVYRGPP-IYEMJOQQSA-L | density = | density_notes = | melting_point = 120 | melting_high = | melting_notes = (decomposes) | boiling_point = | boiling_notes = | solubility = slowly soluble | specific_rotation = }}Calcium gluconate is a mineral supplement and medication.[1] As a medication it is used by injection into a vein to treat low blood calcium, high blood potassium, and magnesium toxicity.[2][1] Supplementation is generally only required when there is not enough calcium in the diet.[1] Supplementation may be done to treat or prevent osteoporosis or rickets.[1] It can also be taken by mouth but is not recommended for injection into a muscle.[2] Side effects when injected include slow heart rate, pain at the site of injection, and low blood pressure.[1] When taken by mouth side effects may include constipation and nausea.[2] Blood calcium levels should be measured when used and extra care should be taken in those with a history of kidney stones.[1] At normal doses use is regarded as safe in pregnancy and breastfeeding.[2][3] Calcium gluconate is made by mixing gluconic acid with calcium carbonate or calcium hydroxide.[4] Calcium gluconate came into medical use in the 1920s.[5] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[6] Calcium gluconate is available as a generic medication.[7] The wholesale cost in the developing world is about US$0.21–1.34 per one-gram vial, 10 ml of 100 mg/ml (10% solution).[8] In the United Kingdom this amount costs the NHS about 0.65 pounds.[7] Medical usesLow blood calcium10% calcium gluconate solution (given intravenously) is the form of calcium most widely used in the treatment of low blood calcium. This form of calcium is not as well absorbed as calcium lactate,[9] and it only contains 0.93% (930 mg/dl) calcium ion (defined by 1 g weight solute in 100 ml of solution to make 1% solution w/v). Therefore, if the hypocalcemia is acute and severe, calcium chloride is given instead. High blood potassiumCalcium gluconate is used as a cardioprotective agent in people with high blood potassium levels, with one alternative being the use of calcium chloride.[19] It is recommended when the potassium levels are high (>6.5 mmol/l) or when the electrocardiogram (ECG) shows changes due to high blood potassium.[7] Though it does not have an effect on potassium levels in the blood, it reduces the excitability of cardiomyocytes, thereby lowering the likelihood of cardiac arrhythmias.[10] Magnesium sulfate overdoseIt is also used to counteract an overdose of Epsom salts magnesium sulfate,[11] which is often administered to pregnant women in order to prophylactically prevent seizures (as in a patient experiencing preeclampsia). Magnesium sulfate is no longer given to pregnant women who are experiencing premature labor in order to slow or stop their contractions (other tocolytics are now used instead due to better efficacy and side effect profiles).{{Citation needed|reason=Reliable source needed for the whole sentence|date=November 2016}} Excess magnesium sulfate results in magnesium sulfate toxicity, which results in both respiratory depression and a loss of deep tendon reflexes (hyporeflexia). Hydrofluoric acid burnsGel preparations of calcium gluconate are used to treat hydrofluoric acid burns.[12][13] This is because calcium gluconate reacts with hydrofluoric acid to form insoluble, non-toxic calcium fluoride. Black widow spider bitesHistorically, IV calcium gluconate was used as an antidote for black widow spider envenomation, often in conjunction with muscle relaxants.[14] This therapy, however, has since been shown to be ineffective.[15][16] Cardiac arrestWhile intravenous calcium has been used in cardiac arrest its general use is not recommended.[2] Cases of cardiac arrest in which it is still recommended include high blood potassium, low blood calcium such as may occur following blood transfusions, and calcium channel blocker overdose.[2] There is the potential that general use could worsen outcomes.[2] If calcium is used calcium chloride is generally the recommended form.[2] Side effectsCalcium gluconate side effects include nausea, constipation, and 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.[17] It is also reported that this form of calcium increases renal plasma flow, diuresis, natriuresis,[18][19] glomerular filtration rate,[20] and prostaglandin E2 and F1-alpha levels.[21] Society and cultureShortages of medical calcium gluconate were reported in November 2012 and November 2015 in the United States.[22][23] {{-}}See also
References1. ^1 2 {{cite book|title=WHO Model Formulary 2008|date=2009|publisher=World Health Organization|isbn=9789241547659|page=497|url=http://apps.who.int/medicinedocs/documents/s16879e/s16879e.pdf|accessdate=8 January 2017|deadurl=no|archiveurl=https://web.archive.org/web/20161213060118/http://apps.who.int/medicinedocs/documents/s16879e/s16879e.pdf|archivedate=13 December 2016|df=}} {{Mineral supplements}}{{Other dermatological preparations}}{{Antidotes}}{{portal bar|Pharmacy and pharmacology|Medicine}}2. ^1 2 3 4 5 6 7 8 9 {{cite web|title=Calcium Salts|url=https://www.drugs.com/monograph/calcium-salts.html|publisher=The American Society of Health-System Pharmacists|accessdate=8 January 2017|deadurl=no|archiveurl=https://web.archive.org/web/20170118041341/https://www.drugs.com/monograph/calcium-salts.html|archivedate=18 January 2017|df=}} 3. ^{{cite web|title=Calcium gluconate Use During Pregnancy {{!}} Drugs.com|url=https://www.drugs.com/pregnancy/calcium-gluconate.html|website=www.drugs.com|accessdate=15 January 2017|deadurl=no|archiveurl=https://web.archive.org/web/20170118043743/https://www.drugs.com/pregnancy/calcium-gluconate.html|archivedate=18 January 2017|df=}} 4. ^{{cite book|last1=Bhattacharya|first1=Suvendu|title=Conventional and Advanced Food Processing Technologies|date=2014|publisher=John Wiley & Sons|isbn=9781118406304|page=391|url=https://books.google.com/books?id=_JSlBAAAQBAJ&pg=PA391|language=en|deadurl=no|archiveurl=https://web.archive.org/web/20170918185033/https://books.google.com/books?id=_JSlBAAAQBAJ&pg=PA391|archivedate=2017-09-18|df=}} 5. ^{{cite book|last1=Tegethoff|first1=F. Wolfgang|title=Calcium Carbonate: From the Cretaceous Period into the 21st Century|date=2012|publisher=Birkhäuser|isbn=9783034882453|page=308|url=https://books.google.com/books?id=eSMGCAAAQBAJ&pg=PA308|language=en|deadurl=no|archiveurl=https://web.archive.org/web/20170918185033/https://books.google.com/books?id=eSMGCAAAQBAJ&pg=PA308|archivedate=2017-09-18|df=}} 6. ^{{cite web|title=WHO Model List of Essential Medicines (19th List)|url=http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|work=World Health Organization|accessdate=8 December 2016|date=April 2015|deadurl=no|archiveurl=https://web.archive.org/web/20161213052708/http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|archivedate=13 December 2016|df=}} 7. ^1 2 3 {{cite book|title=British national formulary : BNF 69|date=2015|publisher=British Medical Association|isbn=9780857111562|pages=680, 694|edition=69}} 8. ^{{cite web|title=Calcium Gluconate|url=http://mshpriceguide.org/en/single-drug-information/?DMFId=109&searchYear=2014|website=International Drug Price Indicator Guide|accessdate=8 December 2016}} 9. ^{{Cite journal| last1 = Spencer| first1 = H.| last2 = Scheck| first2 = J.| last3 = Lewin| first3 = I.| last4 = Samachson| first4 = J.| title=Comparative absorption of calcium from calcium gluconate and calcium lactate in man |journal = The Journal of Nutrition| volume = 89| issue = 3 |pages = 283–292 |year = 1966 |pmid = 4288031| doi = 10.1093/jn/89.3.283}} 10. ^{{Cite journal | last1 = Parham | first1 = W. A. | last2 = Mehdirad | first2 = A. A. | last3 = Biermann | first3 = K. M. | last4 = Fredman | first4 = C. S. | title = Hyperkalemia revisited | journal = Texas Heart Institute Journal / From the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital | volume = 33 | issue = 1 | pages = 40–47 | year = 2006 | pmid = 16572868 | pmc = 1413606 }} 11. ^{{cite journal |vauthors=Omu AE, Al-Harmi J, Vedi HL, Mlechkova L, Sayed AF, Al-Ragum NS |title=Magnesium sulphate therapy in women with pre-eclampsia and eclampsia in Kuwait |journal=Med Princ Pract |volume=17 |issue=3 |pages=227–32 |year=2008 |pmid=18408392 |doi=10.1159/000117797 |url=http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=000117797 |deadurl=no |archiveurl=https://web.archive.org/web/20110615021734/http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=000117797 |archivedate=2011-06-15 |df= }} 12. ^{{cite journal |vauthors=el Saadi MS, Hall AH, Hall PK, Riggs BS, Augenstein WL, Rumack BH |title=Hydrofluoric acid dermal exposure |journal=Vet Hum Toxicol |volume=31 |issue=3 |pages=243–7 |year=1989 |pmid=2741315 |doi=}} 13. ^{{cite journal |vauthors=Roblin I, Urban M, Flicoteau D, Martin C, Pradeau D |title=Topical treatment of experimental hydrofluoric acid skin burns by 2.5% calcium gluconate |journal=J Burn Care Res |volume=27 |issue=6 |pages=889–94 |year=2006 |pmid=17091088 |doi=10.1097/01.BCR.0000245767.54278.09}} 14. ^Pestana, Carlos Dr. Pestana Surgery Notes Kaplan Medical 2013 15. ^{{Cite journal|title = The Treatment of Black Widow Spider Envenomation with Antivenin Latrodectus Mactans: A Case Series|last = Offerman|first = Steven|date = 2011|journal = The Permanente Journal|doi =10.7812/tpp/10-136|pmc=3200105|pmid=22058673|volume=15|issue = 3|pages=76–81}} 16. ^{{Cite journal|url = http://www.sciencedirect.com/science/article/pii/S0196064405810212|title = Clinical presentation and treatment of black widow spider envenomation: A review of 163 cases|last = Clark|first = Richard|date = July 1992|journal = Annals of Emergency Medicine|accessdate = 2014-08-09|doi = 10.1016/S0196-0644(05)81021-2|volume=21|issue = 7|pages=782–787}} 17. ^{{cite journal |author1=Yui-Ming Lam |author2=Hung-Fat Tse |author3=Chu-Pak Lau |title=Continuous Calcium Chloride Infusion for Massive Nifedipine Overdose |journal=Chest |volume=119 |issue=4 |pages=1280–1282 |date=April 2001 |pmid=11296202 |doi=10.1378/chest.119.4.1280}} 18. ^{{cite journal |author1=Ruilope LM |author2=Oliet A |author3=Alcázar JM |author4=Hernández E |author5=Andrés A |author6=Rodicio JL |author7=García-Robles R |author8=Martínez J |author9=Lahera V |author10=Romero JC. | title = Characterization of the renal effects of an intravenous calcium gluconate infusion in normotensive volunteers. |journal=J Hypertens Suppl|volume=7 |issue=6 |pages=S170–1 |date=December 1989 |pmid=2632708 |doi=10.1097/00004872-198900076-00081}} 19. ^{{cite journal |vauthors=Bernardi M, Di Marco C, Trevisani F, Fornalè L, Andreone P, Cursaro C, Baraldini M, Ligabue A, Tamè MR, Gasbarrini G |title=Renal sodium retention during upright posture in preascitic cirrhosis. |journal=Gastroenterology|volume=105 |issue=1 |pages=188–193 |date=July 1993 |pmid=8514034 |doi=10.1016/0016-5085(93)90025-8}} 20. ^{{cite journal |vauthors=Wong F, Massie D, Colman J, Dudley F |title=Glomerular hyperfiltration in patients with well-compensated alcoholic cirrhosis. |journal=Gastroenterology|volume=104 |issue=3 |pages=884–900 |date=March 1993 |pmid=8440439 |doi=10.1016/0016-5085(93)91026-e}} 21. ^{{cite journal |vauthors=Lahera V, Fiksen-Olsen MJ, Romero JC |title= Stimulation of renin release by intrarenal calcium infusion. |journal=Hypertension |volume=15 |issue=2 |pages=149–152 |date=February 1990 |pmid=2404858 |doi=10.1161/01.hyp.15.2_suppl.i149}} 22. ^1 {{Cite journal|url = http://epmonthly.com/article/the-calcium-quandary/|title = The Calcium Quandary|last = Faine|date = December 2013|journal = Emergency Physicians Monthly|doi = |pmid = |access-date = 20 November 2015|last2 = Miller|deadurl = no|archiveurl = https://web.archive.org/web/20151121123038/http://epmonthly.com/article/the-calcium-quandary/|archivedate = 21 November 2015|df = }} 23. ^{{Cite web|title = FDA Drug Shortages|url = http://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Calcium+Gluconate+Injection&source=govdelivery&st=c&tab=tabs-4|website = www.accessdata.fda.gov|accessdate = 2015-11-21|deadurl = no|archiveurl = https://web.archive.org/web/20170918185034/https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Calcium+Gluconate+Injection&source=govdelivery&st=c&tab=tabs-4|archivedate = 2017-09-18|df = }} 5 : Calcium compounds|Gluconates|World Health Organization essential medicines|Antidotes|RTT |
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