Not useful for acute Hypercalcemia?
Correct Answer: Furosemide
Description: Ans. is 'c' i.e., Furosemide Treatment for hypercalcemia depends upono The underlying disease.o The severity of hypercalcemia.o The serum inorganic phosphate level ando The renal hepatic and bone marrow function. o Mild hvpercalcemias< 3 mmol/l (12 mg/dl)-Managed by hydration aloneo More severe hvoercalcemia3.2 to 3.7 mmol/l (13 to 15 mg/dl)-Requires rapid correction measures other than hydration.It requires combination of approaches.o Life threatening hypercalcemia>3.7 mmol/L (15 mg/dL)-Requires emergency measures TreatementOnset of ActionDuration of ActionAdvantagesDisadvantagesMost Useful Therapies Hydration with salineHoursDuring infusionRehydration invariably neededVolume overloadForced diuresis; saline plus loop diureticHoursDuring treatmentRapid actionVolume overload, cardiac decompensation, intesive monitoring, eletrolyte disturbance, inconvenienceBisphosphonates Pamidronate1-2 days10-14 days to weeksHigh potency, intermediate onset of actionFever in 20%, hypophosphatemia, hypocalcemia rarely jaw necrosisZolendronate1-2 days> 3 weeksSame as for pamidronate (may last longer)Same as pamidronate aboveCalcitoninHours1-2 daysRapid onset of action; useful as adjunct in severe hypercalcemiaRapid tachyphylaxisSpecial Use therapies PhosphateOral24 hDuring useChronic management (with hypophosphatemia); low toxicity if P< 4 mg/dLLimited use except as adjuvant or chronic therapyGlucocorticoidsDaysDays, weeksOral therapy, antitumor agentActive only in certain malignancies vitamin D excess and sarcoidosis; glucocorticoid side effectsDialysisHoursDuring use and 24-48 afterwardUseful in renal failure; onset of effect in hours; can immediately reverse life-theratening hypercalcemiaComplex procedure, reserved for extreme or special circumstances
Category:
Medicine
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