When is calcium chloride preferred over calcium gluconate?

CaCl2 preferred for: cardiac arrest (immediate effect, 3x higher elemental Ca per gram), severe hypocalcemia with hemodynamic instability, hyperkalemia cardiac toxicity (membrane stabilization), calcium channel blocker overdose. Gluconate preferred for peripheral IV use (CaCl2 is highly irritating to veins, causes necrosis if extravasation), hypomagnesemia supplementation, neonatal use.

How is calcium given for hyperkalemia with ECG changes?

Calcium chloride 1 g (10 mL of 10% solution) IV over 2 to 5 minutes. Onset of membrane stabilization: 1 to 3 minutes. Duration: 30 to 60 minutes. Repeat if ECG changes persist. Does not lower potassium - must combine with glucose + insulin, sodium bicarbonate (if acidotic), salbutamol, and kayexalate/patiromer for definitive K+ reduction. Calcium gluconate 3 g IV provides equivalent elemental Ca.

Calcium Chloride vs Gluconate Dose Conversion

Convert between calcium chloride and calcium gluconate doses: 1 g CaCl2 = 272 mg elemental Ca = 3 g calcium gluconate = 93 mg elemental Ca. Guide selection for cardiac arrest vs CRRT hypocalcemia vs hyperkalemia.

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Calcium Chloride vs Gluconate Dose Conversion

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Frequently Asked Questions

When is calcium chloride preferred over calcium gluconate?

How is calcium given for hyperkalemia with ECG changes?