Treatment-hypocalcemia
also treat concomitant vitamin D deficiency; Endocrine 2020;69:485
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也要治療維生素 D 缺乏症
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Severely symptomatic: Ca gluconate (1–2 g IV over 20 min) + oral Ca + calcitriol (but takes hrs to work) ± Mg (50–100 mEq/d); 10% CaCl2 in codes or via CVL
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嚴重症狀:
- Ca gluconate 葡萄糖酸鈣(20 分鐘內靜脈注射 1-2 克)+
- 口服鈣 +
- 骨化三醇 Calcitriol(但需要數小時才能發揮作用)
- ± Mg(50-100 mEq/d)
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Consider Ca gtt or PO to follow b/c effect of IV bolus typically lasts only a few hours
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考慮 Ca gtt 或 PO 以遵循 IV 推注的 b/c 效果通常僅持續幾個小時
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Chronic (depends on etiol.): oral Ca (1–3 g/d; citrate better absorbed than carbonate, esp. if achlorhydria or on PPI) and typically calcitriol (0.25–2 mcg/d), and replete vit. D defic. Consider thiazide to ↓ urinary Ca or recombinant PTH 1-84 (if hypopara).
慢性(取決於原因):
* 口服鈣(1-3 g/d;檸檬酸鹽比碳酸鹽更好地吸收,特別是如果胃酸缺乏或 PPI),
* [[寶益兒多種維他命]]
* 通常是骨化三醇(0.25-2 mcg/d),
* 並補充維生素。
* D 缺陷。考慮Thiazide ↓ 尿鈣或重組 PTH 1-84(如果低位)。
Chronic renal failure:
- phosphate binder(s),
- oral Ca,
- calcitriol or analogue