CALCIUM-HYPERCALCEMIA MANAGEMENT

SUMMARY

1. Hydration: 3-4 liters if no contraindications.

2. Bisphosphonates interfere with bone resorption in areas of high turnover (malignancy) and are used in conjunction with saline infusions and calcitonin.

3. Pamidronate and zoledronic acid are representative drugs, favored because of their rapid onset of action & IV formulation.

4. These drugs are associated with osteonecrosis of the jaw in patients with multiple myeloma and metastatic bone disease.

5. Give glucocorticoids for sarcoidosis and myeloma.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].