![]() ![]() Fluoride ions are highly reactive in tissues, causing cellular destruction by binding calcium in cell membranes. Calcium may reverse the negative inotropic effect of calcium channel antagonists however, depressed automaticity and atrioventricular nodal conduction velocity and vasodilatation may not respond to calcium administration.Ĭalcium is also useful in counteracting agents such as hydrofluoric acid (HF) and ammonium bifluoride, which liberate calcium-binding fluoride ions. Administration of intravenous calcium in this scenario increases the efflux of calcium through open channels by significantly raising serum calcium levels above normal. In calcium channel antagonist poisoning, L-type calcium channels in the cardiac and vascular smooth muscle are blocked, resulting in (1) impaired firing of the sinus node pacemaker, (2) decreased rate of conduction through the AV node, (3) decreased cardiac contractility, and (4) decreased vascular tone. The mechanisms of action of antidotal calcium vary by the nature of the poison. Symptomatic electrolyte abnormalities such as hyperkalemia and hypermagnesemia may also benefit from calcium administration. ![]() ![]() fluoride or ethylene glycol poisoning) to treat transfusion-related hypocalcemia (induced by the anticoagulant citrate) or to reverse hypotension and dysrhythmias associated with calcium channel antagonists. Intravenous calcium may be used to correct toxin-induced hypocalcemia (e.g. There are a variety of indications for calcium treatment in the setting of poisoning. What are the potential adverse effects of calcium administration?.What role does topical calcium have for dermal hydrofluoric acid exposure?.What are some indications for calcium therapy in poisoning?.He was discharged with oral pain medications and referred for follow-up the next day with a hand surgeon. After several hours of observation in the emergency department, his pain resolved and there was no progression of skin findings. Serum electrolytes including calcium were within normal limits. ![]() Calcium gluconate gel was reapplied and opioid analgesics were administered. His pain resolved temporarily but returned approximately 20 minutes later. A 2.5% calcium gluconate gel was prepared and placed in the thumb of a latex glove that was applied to the patient’s left hand. He had full range of motion of his thumb, although it was painful. There was no tenderness to palpation along the flexor tendon or at the interphalangeal joints. There were no lesions or puncture wounds. Physical examination revealed erythema and blanching of a 1 cm region on the distal tip of his left thumb. Upon arrival to the emergency department, he was afebrile with pulse of 98/minute, respirations of 16/minute, and blood pressure of 130/70 mm/Hg. Two hours later, he noted severe pain in his left thumb with some erythema on the dorsal surface. He immediately rinsed his hands with water. Upon removing them, he noted a small hole on the dorsal aspect of the thumb of the left glove. Case presentationĪ 35 year old man was working in his garage when he spilled rust remover on his gloves. There are a variety of clinical scenarios and poisonings in which calcium can be used as antidotal therapy. Antagonism of calcium-dependent channels in the myocardium results in hypotension, bradycardia and atrioventricular block. Hypocalcemia, inhibition of calcium efflux, or blockade of calcium’s effects may cause muscle cramps, tetany, and ventricular fibrillation. The normal ranges for serum calcium concentrations are 8.4-10.2 mg/dL for total calcium, and 1.12-1.23 mmol/L for ionized calcium. Calcium is a cation necessary for the normal functioning of a variety of enzymes and organ systems, including muscle and nerve tissue. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |