Calcium Carbonate
(1 tab tid) Classification: Electrolyte replacement or supplements. Antacid Desired Dosage: 500 mg (200 mg Ca), 600
mg
(240 mg Ca), 650 mg (260 mg Ca), 667 mg (266.8 mg Ca), 1 g (400 mg Ca), 1.25 mg (500 mg Ca), 1.5 mg (600 mg Ca) Mode of Action: Essential for nervous, muscular, and skeletal systems. Maintain cell membrane and capillary permeability. Act as an activator in the transmission of nerve impulses and contraction of cardiac,
skeletal and smooth muscles. It is essential for bone formation
and blood coagulation. It is also used a replacement of calcium in deficiency states. It controls of hyperphosphatemia in end-stage renal disease without promoting aluminum absorption. Interactions: Hypercalcemia increases the risk of digoxin toxicity. Chronic use with antacids in renal insufficiency may lead to milk-alkali syndrome. Ingestion by mouth may decrease the absorption of orally administered tetracyclines, fluoroquinolones, phenytoin, and iron salts. Excessive amounts may decrease the effects of calcium channel blockers, atenolol. Concurrent use with diuretics may result in hypercalcemia. Side Effects: y
CNS: syncope, tingling
y
CV: cardiac arrest, arrythmias, bradycardia
y
GI: constipation, nausea, vomting
y
GU: calculi, hypercalciuruia
y
Local: phlebitis (IV only)
Nursing Responsibilities: 1. Monitor VS especially BP and PR. 2. Obtain ECG result. 3. Asses for heartburn, indigestion, abdominal pain. 4. Monitor serum calcium before treatment. 5. Assess for nausea and vomiting, anorexia, thirst, severe constipation.