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Medicine

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Endocrine

Question
14 out of 14
 

Treatment of acute hypercalcemia is: (LQ)



A Normal saline with frusemide

B Plicamycin

C Gallium nitrate

D Mitramycin

Ans. A

Normal saline with forced diuresis with chlorothiazide

Management of Acute hypercalcemia

1). Mild hypercalcemia (up to) 12 mg/dl àManaged by hydration alone

2). More severe hypercalcemia 13 to 15 mg/dl àHydration with saline Forced diuresis: saline: Loop diuretics (Furosemide) promotes calcium excretion

Extra Edge: Thiazide cause hypercalcemia so they are never used in the treatment of hypercalcemia.

Therapy for Chronic Hypercalcemia (Ref. Hari-18th ed., Pg-3111, table 353.4)

Most useful therapies

1). Bisphosphonates : Bisphosphonates reduce calcium resorption

a. 1st generation Etidronate

b. 2nd generation Pamidronate

c. 3rd generation Zoledronate

2). Glucocorticoids : Effective in particular situations such as Vitamin D intoxication : Sarcoidosis, Malignancy

3). Calcitonin

4). Phosphate:

5). Dialysis - Quick and effective and is likely to be needed in severe cases with renal failure

6). Plicamycin

7). Gallium Nitrate

Note:Biphosphonate can cause intense esophagitis

Extra Edge: Strontium is new compound which causes both increase osteoblastic and reduce osteoclastic activity thereby it causes both bone formation and reduces bone resorption. (AIIMS NOV 2008)

8). Surgical excision of the adenoma

Extra Edge: Cinacalcet is new drug.

1). It is a calcimimetic agent that reduces the parathormone level.

2). It is use in treatment of secondary hyperparathyroidism.

Extra Edge: Risedronate

1). It is an orally administered bisphosphonate, inhibits osteoclast-mediated resorption of bone, and modulates bone metabolism in women with postmenopausal osteoporosis.

2). The long half-life of risedronate (480 hrs) for once a –week administration.

Extra Edge:

Teriparatide is the recombinant human N-terminal fragment of endogenous human parathyroid hormone, used in the treatment of some forms of osteoporosis

Endocrine Flashcard List

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