Calcium overdose
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Understanding Calcium Overdose: Risks, Symptoms, and Management
Introduction to Calcium Overdose
Calcium is an essential mineral for bone health and various physiological functions. However, excessive intake can lead to severe health complications. This article synthesizes research findings on calcium overdose, highlighting its causes, symptoms, and management strategies.
Causes of Calcium Overdose
Unintentional Overdose
Unintentional calcium overdose can occur due to misconceptions about its benefits. For instance, a case study reported a 40-year-old woman who overdosed on calcium after a parathyroidectomy, mistakenly believing that higher doses would be more beneficial . This highlights the need for proper patient education regarding supplement use.
Intentional Overdose
Intentional overdose, often seen in cases of self-harm or suicide attempts, can also lead to severe hypercalcemia. A 19-year-old woman developed hypercalcemia and lactic acidosis after being treated with calcium gluconate for an amlodipine overdose . Another case involved a 48-year-old woman who attempted suicide with calcium carbamide, resulting in severe neurological symptoms .
Symptoms of Calcium Overdose
Hypercalcemia
Hypercalcemia, or elevated calcium levels in the blood, is a common symptom of calcium overdose. Symptoms can range from mild to severe and include nausea, vomiting, abdominal pain, and altered mental status. In severe cases, hypercalcemia can lead to life-threatening conditions such as cardiac arrhythmias and metabolic acidosis 24.
Hypocalcemia and QT Prolongation
Interestingly, an overdose of calcium phosphate can lead to hypocalcemia, as seen in a 4-year-old girl who ingested 200 tablets of calcium phosphate. This resulted in marked hypocalcemia and QT interval prolongation, which required immediate medical intervention .
Cardiovascular Complications
Calcium channel blocker (CCB) overdose, often involving drugs like verapamil and diltiazem, can lead to severe cardiovascular issues such as hypotension, bradycardia, and arrhythmias. These complications are often exacerbated by the overdose of calcium supplements used in treatment 467.
Management of Calcium Overdose
Initial Management
The initial management of calcium overdose involves gastrointestinal decontamination using activated charcoal to prevent further absorption of the ingested substance 49. In cases of CCB overdose, early administration of intravenous calcium salts is crucial to reverse hypotension and bradycardia 46.
Advanced Therapies
For severe cases, advanced therapies such as high-dose insulin, glucagon, and catecholamines are employed to stabilize the patient. Insulin, in particular, has been effective in increasing cardiac inotropy and improving survival rates 59. In refractory cases, mechanical support like intra-aortic balloon pumps or extracorporeal membrane oxygenation may be necessary 510.
Monitoring and Supportive Care
Continuous monitoring of vital signs and electrolyte levels is essential. Patients should be observed in a monitored setting for at least 12 to 24 hours, depending on the type of calcium channel antagonist ingested . Supportive care, including fluid management and correction of metabolic abnormalities, is also critical 26.
Conclusion
Calcium overdose, whether unintentional or intentional, poses significant health risks. Understanding the symptoms and effective management strategies is crucial for healthcare providers. Proper patient education on the use of calcium supplements and timely medical intervention can prevent severe complications and improve patient outcomes.
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