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Hypocalcemia (<2 mEq/L OR <1 mmol/L) (Etiology (Drugs (cimetidine,…
Hypocalcemia (<2 mEq/L OR <1 mmol/L)
Etiology
Hyperphosphatemia
Drugs
cimetidine
phosphates
dilantin
loop diurectics
glucocorticoids
Vit. D deficiency
decreased Vit D absorption
lack sunlight exposure
small bowel or biliary disease
pancreatic failure
lack activation of Vit. D
renal disease
Hormone deficiency
hypoparathyroidism
primary
congenital
secondary
iatrogenic surgical complication
Miscellaneous
citrate (in blood products as a preservative)
alkalosis or alkalinisation therapy
sepsis, shock, burns
Signs & Symptoms
Neuromuscular
paresthesis
weakness
cramps
fasiculations
tetany
latent tetany
Chvostek's sign
Trousseau's sign
CVS
decreased myocardial contractility
bradycardia
hypotension
CHF
cardiac arrest
CNS
depression
confusion
seizures
Psychiatry
depression
psychosis
dementia
Investigations
serum electrolytes
serum calcium
phosphate
ionised calcium
ECG
prolonged QT interval (nonspecific)
Treatment
asymptomatic
oral calcium supplement
symptomatic
elemental calcium 100-300 IV in a monitored setting
other corrections
serum magnesium
check level & correct if low
metabolic acidosis
replace calcium before acidosis