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Tetany management requires prompt correction of underlying electrolyte imbalances, primarily focusing on calcium and magnesium replenishment. Acute, severe cases are treated with intravenous (IV) calcium gluconate (10 mL of 10% solution), while chronic management involves oral calcium, vitamin D supplements, and addressing underlying causes like hypoparathyroidism.
Acute Management of Tetany
Immediate Care: Intravenous 10% calcium gluconate is the standard treatment for acute, symptomatic tetany (10 mL over 5–10 minutes).
Alternative Agents: Calcium chloride may be used in critical care settings, although calcium gluconate is preferred due to lower risk of tissue necrosis.
Magnesium Replacement: If hypomagnesemia is present, 10–20 mL of 10% magnesium sulfate should be administered.
Monitoring: Continuous cardiac monitoring (ECG) is recommended during IV calcium administration to detect arrhythmia, especially in patients on digoxin.
Long-Term and Supportive Management
Oral Supplements: Long-term management involves oral calcium and vitamin D supplements (e.g., calcitriol) to maintain serum levels.
Treating the Cause: Addressing the root cause, such as hypoparathyroidism, vitamin D deficiency, or kidney disease, is critical for prevention.
Medications: Antispasmodics may be used to relieve muscle spasms, and sedatives (e.g., benzodiazepines) may be used to treat anxiety-induced hyperventilation.
Lifestyle Adjustments: Increasing dietary intake of calcium and magnesium, as well as managing stress, can help prevent future episodes.
Potential Complications and Considerations
Rapid Correction Risks: Overly rapid correction of calcium can lead to dysrhythmias.
Refractory Cases: In rare or persistent cases, medications like carbamazepine may be considered to reduce nerve excitability.
Safety: Tetany is a medical emergency requiring rapid intervention.

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