Calcium gluconate is produced commercially through three main methods. These three methods are: chemical oxidation of glucose with a hypochlorite solution, electrolytic oxidation of a glucose solution containing a known value of bromide, and a fermentation process where specific microorganisms are grown in a medium containing glucose and various other ingredients.[9]
Medical usesedit
Low blood calciumedit
10% 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,[10] 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 potassiumedit
Calcium gluconate is used as a cardioprotective agent in people with high blood potassium levels, with one alternative being the use of calcium chloride.[11] 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.[2]
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.[12]
Magnesium sulfate overdoseedit
It is also used to counteract an overdose of Epsom salts magnesium sulfate,[13] 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] Excess magnesium sulfate results in magnesium sulfate toxicity, which results in both respiratory depression and a loss of deep tendon reflexes (hyporeflexia).
Hydrofluoric acid burnsedit
Gel preparations of calcium gluconate are used to treat hydrofluoric acid burns.[14][15] The calcium gluconate reacts with hydrofluoric acid to form insoluble, non-toxic calcium fluoride. In addition to a 2.5% calcium gluconate gel being applied directly to the chemical burn, the person may also receive calcium gluconate supplements because the fluoride ion precipitates serum calcium, causing hypocalcemia.[16]
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^ abcBritish national formulary : BNF 69 (69 ed.). British Medical Association. 2015. pp. 680, 694. ISBN 9780857111562.
^ abcWorld Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 497. hdl:10665/44053. ISBN 9789241547659.
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^World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
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^Shindia AA, El-Sherbeny GA, El-Esawy AE, Sheriff YM (March 2006). "Production of gluconic Acid by some local fungi". Mycobiology. 34 (1): 22–29. doi:10.4489/MYCO.2006.34.1.022. PMC3769535. PMID 24039465.
^Spencer H, Scheck J, Lewin I, Samachson J (July 1966). "Comparative absorption of calcium from calcium gluconate and calcium lactate in man". The Journal of Nutrition. 89 (3): 283–292. doi:10.1093/jn/89.3.283. PMID 4288031.
^ abMiller D, Faine B (December 2013). "The Calcium Quandary". Emergency Physicians Monthly. Archived from the original on 21 November 2015. Retrieved 20 November 2015.
^Omu AE, Al-Harmi J, Vedi HL, Mlechkova L, Sayed AF, Al-Ragum NS (2008). "Magnesium sulphate therapy in women with pre-eclampsia and eclampsia in Kuwait". Medical Principles and Practice. 17 (3): 227–232. doi:10.1159/000117797. PMID 18408392. S2CID 3079436.
^el Saadi MS, Hall AH, Hall PK, Riggs BS, Augenstein WL, Rumack BH (June 1989). "Hydrofluoric acid dermal exposure". Veterinary and Human Toxicology. 31 (3): 243–247. PMID 2741315.
^Roblin I, Urban M, Flicoteau D, Martin C, Pradeau D (2006). "Topical treatment of experimental hydrofluoric acid skin burns by 2.5% calcium gluconate". Journal of Burn Care & Research. 27 (6): 889–894. doi:10.1097/01.BCR.0000245767.54278.09. PMID 17091088. S2CID 3691306.
^Urden LD (2014). Critical Care Nursing : Diagnosis and Management (7th ed.). St. Louis, Mo.: Elsevier/Mosby. p. 936. ISBN 978-0-323-09178-7. OCLC 830669119.
^Ruilope LM, Oliet A, Alcázar JM, Hernández E, Andrés A, Rodicio JL, et al. (December 1989). "Characterization of the renal effects of an intravenous calcium gluconate infusion in normotensive volunteers". Journal of Hypertension Supplement. 7 (6): S170–S171. doi:10.1097/00004872-198900076-00081. PMID 2632708.
^Bernardi M, Di Marco C, Trevisani F, Fornalè L, Andreone P, Cursaro C, et al. (July 1993). "Renal sodium retention during upright posture in preascitic cirrhosis". Gastroenterology. 105 (1): 188–193. doi:10.1016/0016-5085(93)90025-8. PMID 8514034.
^Wong F, Massie D, Colman J, Dudley F (March 1993). "Glomerular hyperfiltration in patients with well-compensated alcoholic cirrhosis". Gastroenterology. 104 (3): 884–889. doi:10.1016/0016-5085(93)91026-e. PMID 8440439.
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External linksedit
"Calcium gluconate". Drug Information Portal. U.S. National Library of Medicine.