The extra-skeletal pool of calcium is associated with blood coagulation, maintenance of cardiac function, muscle excitability and basic enzyme reactions , . Calcium may be replaced parenterally during hypocalcemia, hyperkalemia, calcium channel blocker toxicity and during blood transfusion where calcium may be chelated by citrate in the blood components. When replacing calcium via IVPB a dose of 500mg to 1g of calcium chloride can be given over 1-2 hours and repeated every 1 to 2 days based on patient response 2,, . Phosphate may be replaced parenterally to prevent or correct hypophosphatemia 2 . When replacing phosphate parenterally doses can be infused over 4-6 hours while monitoring serum phosphate, magnesium and calcium 3 .
Phosphate replacement can occur via a sodium or potassium replacement product.
Sodium phosphate contains 4mEq sodium and 3mmol phosphate per ml. Potassium phosphate contains 4.4mEq potassium and 3mmol phosphate per ml. NSS administered over 4-6 hours. Magnesium is the second most abundant intracellular cation. Magnesium plays a role in many enzymatic reactions, nerve conduction and muscle and cardiac contractility.