.Calcium bound to anionic sites on serum proteins (eg albumin)

= 40% of the serum calcium

​Bound to proteins

Is the biologically active form

= 50% of the total Calcium

Free ionised

Forms of serum Calcium

Bound to low molecular anions

Complexed with low molecular weight organic anions (phosphate, citrate, oxalate)

= 10% of total serum calcium

Factors which Influence the Concentration of Ionised Calcium

derangedphysiology.com

By Alex Yartsev - Jun 09, 2015

Last updated Wed, 12/08/2021 - 17:42
Topic: Body fluids and electrolytes

PTH = parathormone

Calcitriol = is the active form of vitamin D, normally made in the kidney. It is also known as 1,25-dihydroxycholecalciferol. It is a hormone which binds to and activates the vitamin D receptor in the nucleus of the cell, which then increases the expression of many genes. Calcitriol increases blood calcium (Ca²⁺) mainly by increasing the uptake of calcium from the intestines.

Calcitonin (aka thyrocalcitonin) = is a hormone that is produced by the parafollicular cells (commonly known as C-cells) of the thyroid gland. Calcitonin is involved in helping to regulate levels of calcium and phosphate in the blood, opposing the action of parathyroid hormone.

Follow protocols for Acute hypocalcemia

Postoperative care for total thyroidectomy patiens include monitoring of ADJUSTED (corrected) calcium: check within 12 hours post-op

Normal: 2.20 -2.60 mmol/L

Mild: 2.00 - 2.19

Moderate: 1.91 - 1.99

Severe <= 1.90 (needs iv replacement)

Remember the SE of hypocalcemia: tetany, ECG changes with arrhythmia, Seizure. It starts most commonly with paraesthesia (fingers, around mouths).

Side effects of calcium gluconate include: www.rxlist.com

• nausea,

• vomiting,

• decreased appetite,

• constipation, OR Diarrhoea

• dry mouth,

• increased thirst,

• increased urination,

• tingling sensations,

• hot flashes, and

• a chalky taste following intravenous administration.

https://bnfc.nice.org.uk/drugs/calcium-gluconate

For all calcium salts

Uncommon

Constipation; diarrhoea; hypercalcaemia; nausea

Side-effectsFor calcium gluconate

General side-effects:

Frequency not known

Arrhythmias

Specific side-effects:

Frequency not known

With intravenous use

Circulatory collapse; feeling hot; hyperhidrosis; hypotension; vasodilation; vomiting

With oral use

Gastrointestinal disorder

Thank You!