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Hypocalcaemia

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The Society for Endocrinology have a very clear treatment guide of how much to give & how to give it & when. Additionally there is also there is information produced by the UK medicines information group.

Clinical features
  • Lethargy
  • Nausea/vomiting
  • Causes increased neuromuscular activity: hyperreflexia, paraesthesia, muscle cramps, carpopedal spasm, tetany & seizures
  • Hypotension
  • ECG: prolonged QT, bradycardia and arrythmias
Causes
  • Total thyroidectomy (or parathyroidectomy)
  • Severe Vitamin D deficiency
  • Hypomagneseaemia
  • Pancreatitis
  • Drugs – loop diuretics, glucocorticoids, gentamicin, phosphates, theophylline
Investigations
Ensure you’ve looked at the adjusted calcium (for albumin)
Measure phosphate, PTH, U&Es, Magnesium & vitamin D

Treatment
  • Replace as per trust guidelines or use the above guides
Further Reading & References
  • Hamilton, R.J., 2018. Tarascon adult emergency pocketbook. Jones & Bartlett Learning. 
  • Lewis III, J. L., 2018. Hypocalcemia. MSD Manual Professional Version. 
  • Turner, J., Gittoes, N., Selby, P. and Society for Endocrinology Clinical Committee, 2016. SOCIETY FOR ENDOCRINOLOGY ENDOCRINE EMERGENCY GUIDANCE: Emergency management of acute hypocalcaemia in adult patients. Endocrine connections, 5(5), p.G7.
By Dr Shoaib Hussain

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