calcium carbonate (redirected from Alka-Mints)

calcium /cal·ci·um/ (Ca) (kal´se-um) a chemical element, at. no. 20. Calcium phosphate salts form the dense hard material of teeth and bones. The calcium 2+ ion is involved in many physiologic processes. A normal blood calcium level is essential for normal function of the heart, nerves, and muscles. It is involved in blood coagulation (in which connection it is called coagulation factor IV ). Various calcium salts, including the acetate, carbonate, chloride, glubionate, gluceptate, gluconate, lactate, lactobionate, and phosphate salts, are used as calcium replenishers and supplements.

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calcium carbonate  an insoluble salt, CaCO3, occurring naturally in shells, limestone, and chalk and also used in more purified forms; used as an antacid and calcium replenisher and in the treatment of osteoporosis.

calcium chloride  a salt, CaCl22H2O, used in the treatment of hypocalcemia, electrolyte depletion, and hyperkalemia, and as a treatment adjunct in cardiac arrest and in magnesium poisoning.

calcium citrate  a calcium replenisher also used in the treatment of hyperphosphatemia in renal osteodystrophy.

calcium glubionate  a calcium replenisher, used as a nutritional supplement and for the treatment of hypocalcemia.

calcium gluceptate  a calcium salt used in the treatment and prophylaxis of hypocalcemia and as an electrolyte replenisher.

calcium gluconate  a calcium salt used to treat or prevent hypercalcemia, nutritional deficiency, and hyperkalemia; also used as a treatment adjunct in cardiac arrest.

calcium hydroxide  a salt, Ca(OH)2, used in solution as a topical astringent.

calcium oxalate  a salt of oxalic acid, which in excess in the urine may lead to formation of oxalate calculi.

calcium oxide  lime (1).

calcium phosphate  a salt containing calcium and the phosphate radical: dibasic and tribasic c. phosphate are used as sources of calcium.

calcium polycarbophil  a calcium salt of a hydrophilic resin of the polycarboxylic type; a bulk laxative.

calcium pyrophosphate  the pyrophosphate salt of calcium, used as a polishing agent in dentifrices. Crystals of the dihydrate form occur in the joints in calcium pyrophosphate deposition disease.

calcium sulfate  the sulfate salt of calcium, CaSO4, occurring in the anhydrous form and in a hydrated form (gypsum, q.v.), which upon being calcined forms plaster of Paris.

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calcium carbonate

n.

A calcium salt used as a dietary supplement and as an antacid.

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calcium carbonate (CaCO₂),

precipitated chalk; a white powder sometimes used in antacids.

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calcium (Ca) (kal´sēm),

n a basic element, with an atomic weight of 40.07, found in nearly all organized tissues. Essential for mineralization of bone and teeth. The normal level of it in the blood is 9 to 11.5 mg/100 ml. A deficiency of it in the diet or in use may lead to rickets or osteoporosis. Overexcretion in hyperparathyroidism leads to osteoporotic manifestations. See also factor IV.

calcium binding protein,

n See calmodulin.

calcium, blood,

n See blood calcium.

calcium carbonate,

n brand names: Maalox Antacid, Rolaids Calcium Rich, Tums E-X;
drug class: antacid;
action: neutralizes gastric acidity, supplies calcium;
uses: antacid, calcium supplement.

calcium carbonate and magnesium hydroxide,

n brand name: Rolaids;
drug class: antacid;
action: neutralizes gastric acidity;
use: antacid.

calcium channel blocker,

n a drug that inhibits the flow of calcium ions across the membranes of smooth muscle cells. The reduction of calcium flow relaxes smooth muscle tone and reduces the risk of muscle spasms. Calcium channel blockers are used in the prevention and treatment of coronary artery spasms.

calcium, dietary,

n the amount of absorbable calcium ingested daily.

calcium fluoride,

n a compound that is used as a flux in the manufacture of some silicate cements.

calcium hydroxide,

n a white powder that is mixed with water or another medium and used as a base material in cavity liners and for pulp capping.

calcium oxalate,

n an insoluble sediment in the urine and urinary calculi.

calcium phosphate,

n an odorless, tasteless white powder, the various forms of which are sometimes used as abrasives in dentifrices.

calcium salts,

n.pl the calcium present in salivary fluid as phosphates and carbonates. They are believed to form dental calculus on their precipitation from saliva.

calcium sulfate,

n See alpha-hemihydrate, beta-hemihydrate, gypsum.

calcium tungstate,

n a chemical substance used in crystal form to coat screens; the screens fluoresce when struck by roentgen rays.

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calcium

a chemical element, atomic number 20, atomic weight 40.08, symbol Ca. See Table 6. Calcium is the most abundant mineral in the body. In combination with phosphorus it forms calcium phosphate, the dense, hard material of the bones and teeth. It is an important cation in intra- and extracellular fluid and is essential to the normal clotting of blood, the maintenance of a normal heartbeat, and the initiation of neuromuscular and metabolic activities.

Within the body fluids calcium exists in three forms. Protein-bound calcium accounts for about 47% of the calcium in plasma; most of it in this form is bound to albumin. Another 47% of plasma calcium is ionized. About 6% is complexed with phosphate, citrate and other anions.

Ionized calcium is physiologically active. One of its most important physiological functions is control of the permeability of cell membranes. Parathyroid hormone, which causes transfer of exchangeable calcium from bone into the bloodstream, and calcitriol maintain calcium homeostasis by preventing either calcium deficit or excess.

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calcium arsenate

used extensively as a spray in orchards, constituting a poison hazard for livestock.

avian calcium poisoning

excess calcium in the avian diet, especially in diets low in phosphorus causes nephrosis, visceral gout and urolithiasis.

calcium balance

the balance between calcium intake and losses in feces and urine.

calcium borogluconate

see borogluconate.

calcium carbonate

an insoluble salt occurring naturally in bone, shells and chalk. A common form of supplementary calcium in dogs and cats on meat-based diets, used because of its high concentration of calcium (40%) and absence of phosphorus.

calcium challenge test

an intravenous infusion of calcium will cause increased levels of gastrin in dogs with a gastrinoma. Often used in combination with a secretin test.

calcium channels

see channel.

calcium chloride

a salt used in solution to restore electrolyte balance, to treat hypocalcemia and as an antidote to magnesium poisoning. Is highly irritant and has been discarded generally in favor of less irritating substances, e.g. calcium borogluconate.

calcium cyanamide

agricultural fertilizer capable of being toxic.

calcium cytosolic

see cytosol.

diffusible calcium

see calcium (above).

calcium edetate (Ca-EDTA)

calcium ethylenediamine tetra-acetic acid; the disodium and dipotassium salts are commonly used as anticoagulants in the preservation of blood samples for hematology. A chelating agent, used parenterally in the treatment of lead poisoning. See also edetate.

excess calcium

in all species may cause hypercalcitonism with decreased osteoclastic activity and skeletal remodeling. In dogs, disorders of enchondral ossification with curved radius and osteochondrosis have been demonstrated; secondary iron deficiency anemia occurs in piglets.

calcium fluoride

naturally occurring mineral. Called also fluorspar, fluorite.

calcium gel

contains high levels of calcium; given to cows as a drench or in the feed as a prophylaxis against milk fever.

calcium gluconate

a calcium replenisher and antidote to fluoride or oxalate poisoning.

calcium gout

see calcinosis circumscripta.

calcium homeostasis

maintenance of normal calcium metabolism by the combined effects of adequate alimentary intake, renal excretion, parathyroid hormone involvement, 1,25 dihydroxycholecalciferol (or calcitriol) and calcitonin, plasma protein binding and deposition in tissues.

calcium hydroxide

an astringent compound used topically in solution or lotions; in dentistry used to encourage deposition of secondary dentine. Called also slaked lime. In solution, called lime water.

idiopathic calcium phosphate deposition

thought to be inherited as an autosomal dominant trait in Great Danes commencing in puppies about 5 weeks old, characterized by incoordination with deformity and displacement of the 7th cervical vertebra and mineral deposits in the intervertebral joints, in serous and synovial membranes and mineralization in most other tissues.

calcium lactate

used for supplementing the diet with calcium; contains 18% calcium. As calcium sodium lactate, containing 8% calcium, it is more soluble and can be used in drinking water.

calcium levulinate

a calcium compound used parenterally in the treatment of hypocalcemia; contains 14.8% calcium.

calcium mandelate

administered orally and used as a urinary antiseptic.

calcium nitrate

used as an additive during cheese making to control fermentation. Whey from this cheese may cause nitrate poisoning in pigs.

nondiffusible calcium

protein-bound fractions of plasma calcium.

calcium nutritional deficiency

nutritional deficiency of calcium is rarely primary except in carnivores on an all-meat diet. Secondary deficiency is usually the result of diets having too high a content of phosphorus. The outcome of either deficiency may be nutritional hyperparathyroidism, rickets, osteomalacia, osteodystrophy in horse and pigs, and degenerative arthropathy of cattle, depending on the species, age of the animal and availability of vitamin D. Hypocalcemia may not occur because of the activity of parathyroid hormone, but classical tetany and recumbency can occur if the deficiency is prolonged or if they are precipitated by some other factor.

calcium oxalate

a compound occurring in the urine in crystals and in certain calculi. See also oxalate urolith.

calcium oxide

alkaline and capable of causing gastroenteritis. There is a high concentration in basic slag and this may contribute to that poisoning.

calcium pantothenate

a calcium salt of the dextrorotatory isomer of pantothenic acid; used as a growth-promoting vitamin.

calcium phosphate

one of three salts containing calcium and the phosphate radical: dibasic and tribasic calcium phosphate are used as sources of calcium; monobasic calcium phosphate is used in fertilizer and as a calcium and phosphorus supplement. An important constituent of uroliths.

calcium : phosphorus ratio

the ratio of calcium to phosphorus in the diet, 1 : 1 to 1 : 2 is usually considered to be adequate for proper calcium nutritional status in most animal species. Diets outside this range are likely to cause osteodystrophies. Animals grazing phosphorus-deficient pasture, and those being intensively fed on grain rations which have an abnormally high phosphorus content, are the principal subjects. Horses on heavy grain diets and dogs and cats on meat diets without calcium supplementation are also targets for the disease.

calcium polycarbophil

a hydrophilic agent used as a bulk laxative in the treatment of constipation and diarrhea.

calcium polysulfide

see lime-sulfur.

calcium propionate

see propionic acid.

protein bound calcium

biologically inert fraction of plasma calcium; most is bound to albumin and globulins with a small fraction complexed to organic and inorganic acids.

calcium silicophosphate

crystals of this mineral are thought to contribute physically to the gastroenteritis caused by basic slag poisoning.

calcium sulfate

the main component of plaster of Paris; also used as a dietary source of calcium and inorganic sulfate sulfur.

calcium sulfide, calcium polysulfide

lime-sulfur.

calcium supplements

include calcium carbonate, gluconate, lactate and phosphate; bone flour, bone meal, ground limestone, chalk.

calcium tungstate screens

cards coated with calcium tungstate crystals are used to sandwich film in a light-tight cassette. They fluoresce when exposed to x-rays and, together with the beam, affect the film emulsion. They reduce the exposure factor required.

urinary calcium

calciuria.

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calcium carbonate

Adcal (UK), Alka-Mints, Cacit (UK), Calcarb 600, Calci-Chew, Calci-Mix, Caltrate 600, Children's Pepto Chooz, Florical, Maalox Regular Chewable, Mylanta Children's, Nephro-Calci, Nu-Cal (CA), Os-Cal, Os-Cal 500, Oysco, Oyst-Cal 500, Oystercal 500, Rap-eze (UK), Remegel (UK), Rennie Soft Chews (UK), Rolaids Calcium Rich, SeapCal (UK), Setlers (UK), Tums, Tums E-X, Tums Ultra

Pharmacologic class: Mineral

Therapeutic class: Dietary supplement, electrolyte replacement agent

Pregnancy risk category C (calcium acetate, chloride, glubionate, gluceptate, phosphate), NR (calcium carbonate, citrate, gluconate, lactate)

Action

Increases serum calcium level through direct effects on bone, kidney, and GI tract. Decreases osteoclastic osteolysis by reducing mineral release and collagen breakdown in bone.

Availability

Calcium acetate -

Gelcaps: 667 mg

Tablets: 667 mg

Calcium carbonate -

Capsules: 1,250 mg

Lozenges: 600 mg

Oral suspension: 1,250 mg

Powder: 6.5 g

Tablets: 650 mg, 1,250 mg, 1,500 mg

Tablets (chewable): 750 mg, 1,000 mg, 1,250 mg

Tablets (gum): 300 mg, 450 mg, 500 mg

Calcium chloride -

Injection: 10% solution

Calcium citrate -

Tablets: 950 mg

Calcium glubionate -

Syrup: 1.8 g/5 ml (contains 115 mg of elemental calcium)

Calcium gluceptate -

Injection: 22% solution

Calcium gluconate -

Injection: 10% solution

Tablets: 500 mg, 650 mg, 975 mg

Calcium lactate -

Tablets: 325 mg, 500 mg, 650 mg

Tricalcium phosphate -

Tablets: 600 mg

⊘Indications and dosages

➣ Hypocalcemic emergency

Adults: 7 to 14 mEq I.V. of 10% calcium gluconate solution, 2% to 10% calcium chloride solution, or 22% calcium gluceptate solution

Children: 1 to 7 mEq calcium gluconate I.V.

Infants: Up to 1 mEq calcium gluconate I.V.

➣ Hypocalcemic tetany

Adults: 4.5 to 16 mEq calcium gluconate I.V., repeated as indicated until tetany is controlled

Children: 0.5 to 0.7 mEq/kg calcium gluconate I.V. three to four times daily as indicated until tetany is controlled

Neonates: 2.4 mEq/kg calcium gluconate I.V. daily in divided doses

➣ Cardiac arrest

Adults: 0.027 to 0.054 mEq/kg calcium chloride I.V., 4.5 to 6.3 mEq calcium gluceptate I.V., or 2.3 to 3.7 mEq calcium gluconate I.V.

Children: 0.27 mEq/kg calcium chloride I.V., repeated in 10 minutes if needed. Check calcium level before giving additional doses.

➣ Magnesium intoxication

Adults: Initially, 7 mEq I.V.; subsequent dosages based on patient response

➣ Exchange transfusions

Adults: 1.35 mEq calcium gluconate I.V. with each 100 ml of citrated blood

➣ Hyperphosphatemia in patients with end-stage renal disease

Adults: Two tablets P.O. daily, given in divided doses t.i.d. with meals. May increase gradually to bring serum phosphate level below 6 mg/dl, provided hypercalcemia doesn't develop.

➣ Dietary supplement

Adults: 500 mg to 2 g P.O. daily

Off-label uses

• Osteoporosis

Contraindications

• Hypersensitivity to drug
• Ventricular fibrillation
• Hypercalcemia and hypophosphatemia
• Cancer
• Renal calculi
• Pregnancy or breastfeeding

Precautions

Use cautiously in:
• renal insufficiency, pernicious anemia, heart disease, sarcoidosis, hypercrenal insufficiency, pernicious anemia, heart disease, sarcoidosis, hyperparathyroidism, hypoparathyroidism
• history of renal calculi
• children.

Administration

☞ When infusing I.V., don't exceed a rate of 200 mg/minute.
• Keep patient supine for 15 minutes after I.V. administration to prevent orthostatic hypotension.
• Administer P.O. doses 1 to 1½ hours after meals.
• Know that I.M. or subcutaneous administration is never recommended.
• Be aware that I.V. route is preferred in children.
• Be alert for extravasation, which causes tissue necrosis.

Route	Onset	Peak	Duration
P.O.	Unknown	Unknown	Unknown
I.V.	Immediate	Immediate	0.5-2 hr

Adverse reactions

CNS: headache, weakness, dizziness, syncope, paresthesia

CV: mild blood pressure decrease, bradycardia, arrhythmias, cardiac arrest (with rapid I.V. injection)

GI: nausea, vomiting, diarrhea, constipation, epigastric pain or discomfort

GU: urinary frequency, renal calculi

Metabolic: hypercalcemia

Musculoskeletal: joint pain, back pain

Respiratory: dyspnea

Skin: rash

Other: altered or chalky taste, excessive thirst, allergic reactions (including facial flushing, swelling, tingling, tenderness in hands, and anaphylaxis )

Interactions

Drug-drug. Atenolol, fluoroquinolones, tetracycline: decreased bioavailability of these drugs

Calcium channel blockers: decreased calcium effects

Cardiac glycosides: increased risk of cardiac glycoside toxicity

Iron salts: decreased iron absorption

Sodium polystyrene sulfonate: metabolic alkalosis

Verapamil: reversal of verapamil effects

Drug-diagnostic tests. Calcium: increased level

Drug-food. Foods containing oxalic acid (such as spinach), phytic acid (such as whole grain cereal), or phosphorus (such as dairy products): interference with calcium absorption

Patient monitoring

• Monitor calcium levels frequently, especially in elderly patients.

Patient teaching

• Instruct patient to consume plenty of milk and dairy products during therapy.
• Refer patient to dietitian for help in meal planning and preparation.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.