Hypercalcemia of Malignancy

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Author:
giddyupp
ID:
67182
Filename:
Hypercalcemia of Malignancy
Updated:
2011-02-17 21:47:25
Tags:
Hypercalcemia Malignancy PHPR523 Test3
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Hypercalcemia of Malignancy
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  1. What is the equation for corrected Calcium?
    Ca + 0.8(4 - albumin)
  2. What is the tx for hypercalcemia of malignancy if there are no sx present and Ca < 14 mg/dL?
    • Encourage oral fluids
    • Increase Na intake
    • Increase ambulation
    • Monitor: Ca, Phos, K, BUN, SCr, Alb, fluid status
  3. What is the tx for hypercalcemia of malignancy if there are sx present or Ca > 14 mg/dL?
    • NS + Calcitonin + Bisphosphonate
    • Monitor: Ca, Phos, K, BUN, SCr, Alb, fluid status
  4. What is the MOA of NS in hypercalcemia?
    • expands intracellular volume
    • increases renal Ca excretion
  5. What is the MOA of diuretics in hypercalcemia?
    inhibition of Ca reabsorption by the kidneys
  6. What is the MOA of Calcitonin in hypercalcemia?
    • inhibits osteoclastic bone resorption
    • increases renal excretion of Ca
  7. What is the MOA of bisphosphonates in hypercalcemia?
    • inhibits osteoclastic bone resorption
    • inhibits bone crystal dissolution
  8. What is the dosing schedule of Calcitonin for hypercalcemia?
    SQ q 6h (8 dose max)
  9. What is the differince between the onset of action for Calcitonin and the onset of all other agents used for hypercalcemia?
    • Calcitonin = a few hrs
    • Others = 48hrs
  10. What is the DOA of NS for hypercalcemia?
    48hrs
  11. What is the DOA of Calcitonin for hypercalcemia?
    24hrs
  12. What is the DOA of bisphosphonates for hypercalcemia?
    ~30d
  13. What are the SE of NS in hypercalcemia?
    • fluid overload (use +/- diuretics)
    • decreases K
    • decreases Mg
    • hyponatremia
  14. What are the SE of Calcitonin for hypercalcemia?
    • tachyphylaxis
    • GI upset
    • Rash/flushing
  15. What are the SE of bisphosphonates for hypercalcemia?
    • decrease Ca
    • increase Phos
    • decrease Mg
    • increase SCr (not really if you follow dir.)
    • Rash
    • Fever
    • Thrombophlebitis
    • Osteonecrosis of the jaw

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