Canonical Question
Electrolytes
Master answer
Calcium
- Total body stores of calcium = 25,000mmol (400mmol/kg)
- Distribution
- 99% in poorly exchangeable pool (bone, teeth)
- 1% in readily exchangeable pool, majority of this is plasma
- 2.15-2.65mmol/l in plasma
- Absorbed from gut (increased with calcitriol)
- Homeostasis maintained
- Short-term by distal tubular resorption, under control of PTH and calcitriol
- Long-term by bone osteoclast activity, influenced by PTH, calcitriol and calcitonin
Role of Calcium
- Intracellular:
- Myocyte excitation-contraction coupling
- Required for cross bridge cycling
- Regulates mitotic function
- Intracellular second messenger for enzyme activation
- Cell membrane:
- Flow of calcium is responsible for automaticity in SA and AV nodes
- Calcium channels are involved in membrane excitation
- Extracellular:
- Forms part of the mineral matrix giving bone and teeth strength
- Involved in fibrinolysis
- Factor IV in the clotting cascade, required for binding of other clotting factors to phospholipids
- Required for the complement cascade
Ca Gluconate vs Ca Chloride
| Calcium gluconate | Calcium chloride | |
|---|---|---|
| Chemical structure | 2 gluconate ions 1 Ca2+ ions | 2 chloride ions 1 Ca2+ ions |
| Dose | 10ml of 10% | 10ml of 10% |
| Potency | 2.2mmol in 10ml | 6.8mmol in 10ml |
| pH | 6.0-8.2 | 5.5-7.5 |
| Difference in adverse effects | Somewhat irritant to veins | Very irritable to veins |
| Administration | Can be safely given through peripheral IV cannulae | Best through CVC Can use in PIVC in resuscitation |
Mooney 2016
Exam appearances
| Exam | Exact wording | Relationship | Success |
|---|---|---|---|
| 2011A Q04 | Outline the role of calcium in the body (70% of marks). Outline the differences between calcium chloride and calcium gluconate solutions (30% of marks). | historical_member | — |