What is the dosage of Calcium Chloride for calcium channel blocker overdose?

• A. 0.5 gram IV/IO
• B. 2 gram IV/IO
• C. 1 gram IV/IO
• D. 1.5 gram IV/IO

Answer: (C)

In calcium channel blocker overdose, giving calcium helps overcome the blockade by raising serum calcium, which drives more calcium into cardiac and vascular smooth muscle to improve contractility and conduction. The standard initial bolus is one gram of calcium chloride given IV or IO, because this amount rapidly raises ionized calcium without needing a large fluid load. If the patient remains unstable after the bolus, you may repeat the dose or start a calcium infusion. Calcium chloride is more calcium-dense than calcium gluconate, so it acts quickly, but it carries a higher risk of tissue injury if it extravasates, so monitor the IV site carefully. The other options either provide too little to have an immediate effect or represent higher, nonstandard initial doses.