Calcium 600/vitamin D

Clinical Medications Worksheets Generic Name Calcium carbonate/ Vitamin D Peak Unknown

Trade Name Calcium 600 + D Onset Unknown

Classification mineral and electrolyte replacements/supplements Duration unknown

Dose 1000mg/400 IU

Route PO

Time/frequency qd

For IV meds, compatibility with IV drips and /or solutions N/A

Mechanism of action and indications (Why med ordered) Mineral/electrolyte/vitamin supplement

Nursing Implications (what to focus on) Contraindications/warnings/interactions H y p er ca lc e m ia

R e n al ca lc ul i

V e nt ri c ul ar fi br ill at io n C er e al s, s pi n a c h , or r h

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Milk of Magnesia: Use of magnesium-containing products with a vitamin D analog may increase the risk of hypermagnesemia. Norvasc: Calcium-containing products may decrease the effectiveness of calcium channel blockers by saturating calcium channels with calcium. Lorazepam: A number of studies have reported that antacids can delay the gastrointestinal absorption and reduce the peak plasma concentration (Cmax) of some benzodiazepines, including clorazepate, chlordiazepoxide and diazepam, although the overall extent of absorption is generally not affected.

Nursing Process- Assessment (Pre-administration assessment) Observe patient closely for symptoms of hypocalcemia (paresthesia, muscle twitching, laryngospasm, colic, cardiac arrhythmias, Chvostek's or Trousseau's sign). Notify physician or other health care professional if these occur.

Lab value alterations caused by medicine Monitor serum calcium or ionized calcium, chloride, sodium, potassium, magnesium, albumin, and parathyroid hormone (PTH) concentrations. May cause decreased serum phosphate concentrations with excessive and prolonged use. When used to treat hyperphosphatemia in renal failure patients, monitor phosphate levels.

Be sure to teach the patient the following about this medication Instruct patient not to take enteric-coated tablets within 1 hr of calcium carbonate; this will result in premature dissolution of the tablets. Do not administer concurrently with foods containing large amounts of oxalic acid (spinach, rhubarb), phytic acid (brans, cereals), or phosphorus (milk or dairy products). Administration with milk products may lead to milk-alkali syndrome (nausea, vomiting, confusion, headache). Do not take within 1-2 hr of other medications if possible. Instruct patients on a regular schedule to take missed doses as soon as possible, then go back to regular schedule. Advise patient that calcium carbonate may cause constipation. Review methods of preventing constipation (increasing bulk in diet, increasing fluid intake, increasing mobility) and using laxatives. Severe constipation may indicate toxicity. Advise patient to avoid excessive use of tobacco or beverages containing alcohol or caffeine.

Assessment Why would you hold or not give this med? Occurrence of unwanted side effects. Nausea, vomiting, anorexia, thirst, severe constipation, paralytic ileus, and bradycardia.

Evaluation Check after giving Increase in serum calcium levels.