Patient with HR 92 can we give ca gluconate

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calcium gluconate prescribing information contraindications digoxin hyperkalemia ECG monitoring

HR 92 by itself is not a contraindication to IV calcium gluconate. Do not give it based on heart rate alone. Give calcium only for a clear indication, such as:
  • Hyperkalemia with ECG changes
  • Symptomatic or severe hypocalcemia
  • Calcium-channel blocker toxicity
  • Hypermagnesemia
Before giving it, check the ECG/rhythm, potassium and ionized calcium if available, renal status, IV access, and medication list.
Avoid or use specialist-directed caution if the patient has hypercalcemia, is receiving digoxin or another cardiac glycoside, or is a neonate receiving ceftriaxone. Administer IV calcium slowly with continuous ECG monitoring, because rapid administration can cause bradycardia or arrhythmia. The DailyMed prescribing information specifically warns about arrhythmias with cardiac glycosides.
If this is for suspected hyperkalemia: calcium stabilizes the myocardium but does not lower potassium, so it must be followed by potassium-lowering treatment per local protocol.
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