Definition
In contrast to hypercalcemia, hypocalcemia outlines a clinical condition in which the concentration of calcium in the blood is lower than normal:
Calcium ionized in the blood <4.5 mg / dl → hypocalcemia
Total blood serum <9 mg / dl → hypocalcemia
Hypocalcemia is a pseudo-pathological alteration that can occur in both adults and children.
Causes
Hypocalcemia can be induced by various factors: phosphorus accumulation, alcoholism, vitamin D deficiency / resistance to action, magnesium deficiency, mother's diabetes (→ neonatal hypocalcemia), anticonvulsant drugs, infections, acute pancreatic inflammation, insufficiency chronic kidney disease, hypochloridria, hypoparathyroidism, pathological stress, severe burns.
Symptoms
Children affected by hypocalcemia tend not to have obvious symptoms; sometimes, in affected children, tremors, muscular contractions and convulsions are observed. In adults, the symptomatology of hypocalcemia is characterized by: tetanic syndrome (exaggerated increase in muscular contractility), tingling, numbness. The symptoms get worse in pregnancy and in episodes of strong emotional stress.
- Complications: arrhythmias, convulsions, tetanus cramps, laryngospasm, tachycardia.
Information on Hypocalcemia - Hypocalcemia Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Hypocalcemia - Hypocalcemia Drugs.
drugs
Hypocalcemia is rather easy to treat, through the integration of calcium (calcium lactate, calcium chloride and calcium gluconate supplementation); clearly, intervention readiness minimizes the risk of complications, which could also be very dangerous, especially in the case of childhood hypocalcemia.
For acute forms, an injection of calcium gluconate or calcium chloride is recommended.
In hypoparathyroidism caused by parathyroidectomy, calcium is recommended as a preventive therapy for hypocalcemia; in severe forms associated with chronic renal failure in patients undergoing partial parathyroidectomy, calcium administration is recommended (indicative dosage: 1 gram of elemental calcium per day, for 5-10 days).
For all variants of hypocalcemia, vitamin D supplementation alone does not seem sufficient. Only if the patient integrates the diet with calcium and phosphate, vitamin D therapy for the treatment of hypocalcemia can be effective.
It is recommended to constantly monitor the plasma calcium concentration at intervals of one week (initially) or every 1-3 months, based on the severity of hypocalcemia.
- Calcium Gluconate (eg Calcium Gluconate B Braun): indicatively, for the acute forms of hypocalcemia, it is recommended to take the drug intravenously at a dose ranging from 500 to 2000 mg per day (5-20 ml); it is recommended not to exceed the infusion rate of 0.5-2 ml / min. The dosage can be increased as needed, based on the plasma calcium concentration. The most commonly used dose in therapy to treat hypocalcemia is between 1 g and 1.5 g, splitting the load into several daily doses. Repeat the drug every 1-3 days, as needed. The drug is also available as tablets taken orally, at a dose of 500-2000 mg per day (in 2-4 doses). The drug is also available in association with calcium carbonate (eg Calcium Sandoz): available in effervescent tablets formulated with 1132 mg of calcium lactate gluconate and 875 mg of calcium carbonate, equivalent to 500 mg of elemental calcium. It is recommended to take 1 gram of active ingredient a day, dissolving the tablet in a glass of water.
- Calcium carbonate (eg. Recal, Metocal, Cacit): for moderate forms of hypocalcemia, it is recommended to take a variable dose of 900 to 2500 mg per day, equally divided into two daily doses. The dose described above can be modulated by the doctor based on the patient's response.
- Calcitriol (eg rocaltrol, Difix): particularly indicated for the treatment of hypocalcemia associated with renal failure: in fact, the drug does not require a metabolic effort on the part of the kidney. Orally, initially take the drug at a dose of 0.25 mcg, once a day. Maintenance therapy plans to increase by 0.25 mcg / dose at 4-8 week intervals, in full compliance with the directions given by the doctor. The drug is also available as an infusion for parenteral administration: take 0.5 mcg of the drug intravenously, three times a week. The maintenance dose, in this case, plans to increase the dose by 0.25-0.5 mcg / dose, at 2-4 week intervals. The dose just described is indicated to treat hypocalcemia in adults; for childhood hypocalcemia the dosage must be modulated and customized by the doctor based on the severity of the condition, the weight of the child and age.
- Dihydrotachisterolo (eg Atiten): in the form of a solution, it is recommended to take 1 ml of product - corresponding to about 30 drops - equivalent to 1 mg of Dihydrotachisterol. Indicated for the treatment of hypocalcemia associated with hypoparathyroidism. The average dosage of drug corresponds to 15-45 drops of solution (0.5-1.5 mg of active); to underline, however, that the precise dosage must be customized according to the level of calcium in the plasma.
- Ergocalciferoloo vitamin D2 (eg Ostelin): for adults suffering from hypocalcemia, the dosage plans to take a dose of drug varying from 50, 000 to 200, 000 units by mouth or intramuscularly, once a day. For children with familial hypocalcemia, take the drug orally or intramuscularly at a dose of 1000-2000 mcg per day (corresponding to 40, 000-80, 000 IU) with a phosphate supplement. The daily dosage of vitamin D2 can be increased by 250-500 mcg (10, 000-20, 000 IU) every 3-4 months. For more information: consult your doctor.
- Globate calcium: orally, it is recommended to take an active dose of 15 ml, three times a day, on an empty stomach. 5 ml of product provide the body with 115 mg of elemental calcium. The dosage just described is indicated for the treatment of hypocalcemia in adults; in children, the dosage depends on the age, weight and severity of the symptoms. Consult your doctor.
- Alfacalcidol (eg Dediol, Geniad, Sefal, Deril, Diserinal): also called 1 alpha-hydroxycholecalciferol, alfacalciferol is a synthetic drug of vitamin D, able to exercise the same effects as the active form of vitamin D, without request the intervention of the renal apparatus. Indicatively, it is customary to recommend taking the drug at a dose of 0.25-1 mcg per day (in the form of tablets taken by mouth), for the treatment of hypocalcemia in adults.
