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What are the other drugs for treating hypercalcemia?

waelhammad
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2022-11-19
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A 54-year-old female presents with drowsiness to the emergency. Her BP is 140/90 mm of Hg with pulse after rate 100/minute. Her investigations reveals serum creatinine 2.4 mg/dL, Na 140 mEq/L, K 4.3 mEq/L. Complete blood count (CBC) and liver function test (LFT) is normal. CT scan head is normal. Her past evaluation reveals a cervical lymph node fine needle aspiration cytology (FNAC) suggestive of granulomatous inflammation. Her bone marrow examination is suggestive of non-Hodgkin’s lymphoma.

What are the other drugs for treating hypercalcemia?

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waelhammad
2022-11-19
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• Glucocorticoids

Use in → Malignancy related local osteolytic hypercalcemia Vitamin D/A intoxication Sarcoidosis Prednisolone 20–50 mg BD (40–100 mg/day)

• Oral phosphate

For chronic management in patients with hypophosphatemia 1–1.5 g/day of phosphorus in divided doses IV phosphate in severe hypercalcemia + cardiac/renal failure Phosphate dose >1500 mg over 6–8 hours S/E ectopic calcification, renal damage, fatal hypocalcemia

• Dialysis: Useful in renal failure

• Obsolete

– Plicamycin (Mithramycin) 25 μg/kg IV

S/E—N, hepatotoxicity, proteinuria, thrombocytopenia – Gallium nitrate. Review of bone marrow slides showed no evidence of NHL. Cervical lymph node biopsy was done which revealed tuberculous lymphadenopathy.

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