Is there a cure for hyper calcimia?

Question

Is there a cure for hyper calcimia?

Answer 1

Initial therapy: fluids and diuretics:hydration, increasing salt intake, and forced diuresis.

hydration is needed because many patients are dehydrated due to vomiting or renal defects in concentrating urine.

increased salt intake also can increase body fluid volume as well as increasing urine sodium excretion, which further increases urinary calcium excretion (In other words, calcium and sodium (salt) are handled in a similar way by the kidney. Anything that causes increased sodium (salt) excretion by the kidney will, en passant, cause increased calcium excretion by the kidney)

after rehydration, a loop diuretic such as furosemide can be given to permit continued large volume intravenous salt and water replacement while minimizing the risk of blood volume overload and pulmonary edema. In addition, loop diuretics tend to depress renal calcium reabsorption thereby helping to lower blood calcium levels

can usually decrease serum calcium by 1-3 mg/dL within 24 h

caution must be taken to prevent potassium or magnesium depletion

[edit]Additional therapy: bisphosphonates and calcitonin

bisphosphonates are pyrophosphate analogues with high affinity for bone, especially areas of high bone-turnover.

they are taken up by osteoclasts and inhibit osteoclastic bone resorption

current available drugs include (in order of potency): (1st gen) etidronate, (2nd gen) tiludronate, IV pamidronate, alendronate, risedronate, and (3rd gen) zoledronate

all patients with cancer-associated hypercalcemia should receive treatment with bisphosphonates since the 'first line' therapy (above) cannot be continued indefinitely nor is it without risk. Further, even if the 'first line' therapy has been effective, it is a virtual certainty that the hypercalcemia will recur in the patient with hypercalcemia of malignancy. Use of bisphoponates in such circumstances, then, becomes both therapeutic and preventative

patients in renal failure and hypercalcemia should have a risk-benefit analysis before being given bisphosphonates, since they are relatively contraindicated in renal failure.

Calcitonin blocks bone resorption and also increases urinary calcium excretion by inhibiting renal calcium reabsorption

Usually used in life-threatening hypercalcemia along with rehydration, diuresis, and bisphosphonates

Helps prevent recurrence of hypercalcemia

Dose is 4 Units per kg via subcutaneous or intramuscular route every 12 hours, usually not continued indefinitely

[edit]Other therapies

rarely used, or used in special circumstances

plicamycin inhibits bone resorption (rarely used)

gallium nitrate inhibits bone resorption and changes structure of bone crystals (rarely used)

glucocorticoids increase urinary calcium excretion and decrease intestinal calcium absorption

no effect in calcium level in normal or 1' hyperparathyroidism

effective in hypercalcemia due to osteolytic malignancies (multiple myeloma, leukemia, Hodgkin's lymphoma, carcinoma of the breast) due to antitumor properties

also effective in hypervitaminosis D and sarcoidosis

dialysis usually used in severe hypercalcemia complicated by renal failure. Supplemental phosphate should be monitored and added if necessary

phosphate therapy can correct the hypophosphatemia in the face of hypercalcemia and lower serum calcium

Answer 2

Great answer from Armed!... I have hypercalcemia, potassium, chloride, protein are also high. Co2 is low. A new doctor then did a PTT to test the parathyroid...unfortunately it came back negative..? Having MRI in a couple of hours of my total spine as it has been progressively degenerating for the last year. Still "movable" and "flexible" yet NOT "stable". I had to stop going to a chiropractor because the "inside" of my spine is extremely tender and I have not been able to "sleep" on my back in over a year...Blood pressure drops when I finally get halfway comfortable lying on my side to go to sleep...possibly due to "hyperviscosity" due to the hypercalcemia... tired-weak-small seizures-thinking and concentrating are totally off (HA! On top of being A.D.D.!)... FIND THE "UNDERLYING CAUSE"!!! ASAP!.. Too high of a calcium level can lead to coma or death... Mine is only 10.9... getting up to 11-12+ is not good.