HIGHER BLOOD CALCIUM LEVELS-TREATMENTS
When the blood calcium levels rises above the normal range the condition is known by medical terms as Hypercalcemia.If left untreated it may result into serious unwanted consequences.
Symptoms
Although the patient is asymptomatic but he may demonstrate the following consequences:-
1.Weariness
2.Renal stones
3.Constipation
4.Stomach pain
5.Weakness
6.Confusion
7Delirium
Causative Diseases
These causes can easily be remembered by the ananym CHIMPANZEES
Calcium suplementations used in excess
Hyperparathyroidsm
Iatrogenic (Urinary retension of calcium by overuse of thiazide diuretics)
Malignancy/Milk alkali syndrom caused by excessive intake of calcium and alkali through milk.
Paget's disease(Abnormal bone destruction and reformation)
Addison's Disease
Neoplasm
Zollinger-Ellison's syndrom
Excess vitamin-D
Excess vitami-A
Sarcoid a disease in which there are abnormal collections of inflammatory cells to form granuloma
TREATMENT OPTIONS
1.Rehydration with saline and diuresis with loop diuretics like furosamide
2.Bisphosphonates
3.Calcitonin
4.Gallium nitrae
5.Plicamycin
6.Glucocorticoids
1.Bisphosphonates
a)Etidronate
b)Pamidronate
Mechanism Bisphosphonates are working by inhibiting osteoclastic activity that means they reduce both bone resorption and bone formation of hydroxyapatite crystals.
Routes of admn:- Etidronate by oral and i.v.
Pamidronate by i.v. only
Uses 1.Malignancy associated hypercalcemia
2.Paget's disease
3.Bone osteoporosis.
2.Calcitonin
A 32 member aminoacid peptide synthesized and secreted by the parafollicular C cells of the thyroid gland
Mechanism
It decreases osteoclastic bone resorption as well as kidney calcium and phosphorus reabsorption.
Uses
1.Paget's disease
2.Hypercalcemia
3.Osteoporosis
Salmon fish calcitonin is more potent than humen calcitonin and have longer half life.
Side effects
1.Allergic reactions
2.Gastri Intestinal distress
3.Flushing,redness and tingling of the face.
3.Gallium nitrate
Gallium nitrate is working by bone resorption and thereby it decreases blood calcium levels.
Use Malignant hypercalcemia
Toxicity Nephrotoxic
4.Plicamycin
This is a cell destructing antibiotic reduces blood calcium levels
Mechanism
It inhibit the action of PTH on osteoclasts and also inhibiting the action of vit.D
Use Malignant hypercalcemia and Paget's disease
Toxicity 1.Thrombocytopenia and hemorrhage
2.Liver and Kidney toxicity
3.Nausea and vomiting and loss of appetite.
5.Glucocorticoids
(e,g) Prednisone
Mechanism These medicines work by decreasing calcium absorption by the intestines and increasing the calcium excretion by kidneys.
Uses Hypercalcemia due to lymphoma and sarcoid.
TREATMENT OPTIONS
1.Rehydration with saline and diuresis with loop diuretics like furosamide
2.Bisphosphonates
3.Calcitonin
4.Gallium nitrae
5.Plicamycin
6.Glucocorticoids
1.Bisphosphonates
a)Etidronate
b)Pamidronate
Mechanism Bisphosphonates are working by inhibiting osteoclastic activity that means they reduce both bone resorption and bone formation of hydroxyapatite crystals.
Routes of admn:- Etidronate by oral and i.v.
Pamidronate by i.v. only
Uses 1.Malignancy associated hypercalcemia
2.Paget's disease
3.Bone osteoporosis.
2.Calcitonin
A 32 member aminoacid peptide synthesized and secreted by the parafollicular C cells of the thyroid gland
Mechanism
It decreases osteoclastic bone resorption as well as kidney calcium and phosphorus reabsorption.
Uses
1.Paget's disease
2.Hypercalcemia
3.Osteoporosis
Salmon fish calcitonin is more potent than humen calcitonin and have longer half life.
Side effects
1.Allergic reactions
2.Gastri Intestinal distress
3.Flushing,redness and tingling of the face.
3.Gallium nitrate
Gallium nitrate is working by bone resorption and thereby it decreases blood calcium levels.
Use Malignant hypercalcemia
Toxicity Nephrotoxic
4.Plicamycin
This is a cell destructing antibiotic reduces blood calcium levels
Mechanism
It inhibit the action of PTH on osteoclasts and also inhibiting the action of vit.D
Use Malignant hypercalcemia and Paget's disease
Toxicity 1.Thrombocytopenia and hemorrhage
2.Liver and Kidney toxicity
3.Nausea and vomiting and loss of appetite.
5.Glucocorticoids
(e,g) Prednisone
Mechanism These medicines work by decreasing calcium absorption by the intestines and increasing the calcium excretion by kidneys.
Uses Hypercalcemia due to lymphoma and sarcoid.
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