ISBP 2a2 E1 fall 2022 Hypercalcemia

Hypercalcemia

Serum Calcium > 10.5 and < 13 mg/dL

is?

• Mild-to-moderate

• Severe

• Hypercalcemic crisis

Hypercalcemia

Serum Calcium > 13 mg/dL

is?

• Mild-to-moderate

• Severe

• Hypercalcemic crisis

Hypercalcemia

Serum Calcium > 15 mg/dL

is?

• Mild-to-moderate

• Severe

• Hypercalcemic crisis

hyperparathyroidism can cause?

• Hypocalcemia

• Hypercalcemia

Hypercalcemia

Goals of therapy

• prevent arrhythmias

• prevent bone loss

Hypercalcemia treatment

IV isotonic fluids – immediate onset

NS bolus 1-2 L followed by 250-300 mL/h

• 1^st line (symptomatic management)

• asymptomatic management

• used in hypercalcemia of malignancy (tendancy of medication to get worse)

Hypercalcemia treatment

Loop diuretics – immediate onset

Furosemide 40-80 mg IV q1-4 h

• 1^st line (symptomatic management)

• asymptomatic management

• used in hypercalcemia of malignancy (tendancy of medication to get worse)

Hypercalcemia treatment

Calcitonin

IM/subcutaneous salmon calcitonin = 4 units/kg every 12h

• 1^st line (symptomatic management)

• asymptomatic management

• used in hypercalcemia of malignancy (tendancy of medication to get worse)

Hypercalcemia treatment

Bisphosphonates

• 1^st line (symptomatic management)

• asymptomatic management

• used in hypercalcemia of malignancy (tendancy of medication to get worse)