Acute Treatment of Hypercalcemia
Normal saline (4–6 L/d) h during Rx
Natriuresis → ↑ renal Ca excretion 排鈉 → ↑ 腎鈣排泄
Furosemide h during Rx
Use cautiously, only if volume overloaded
Bisphosphonates 1–2 d var.
Inhibit osteoclasts, useful in malignancy; caution in renal failure; risk of jaw osteonecrosis; monitor for hypocalcemia
- 抑制破骨細胞，對惡性腫瘤有用
- 腎功能衰竭要小心
- 頜骨壞死的風險
- 監測低鈣血症
Calcitonin h ~48 hrs
- Bridging Rx, quickly develop tachyphylaxis急速耐藥性
Glucocorticoids days days
- Useful in some malig, granulomatous disorders & vitamin D intox.
- pred. 20mg
Denosumab (JCEM 2014;99:3144) days months
- Monoclonal Ab against RANKL; typically used in hyperCa of malignancy; not renally cleared
- 針對 RANKL 的單克隆抗體；通常用於惡性腫瘤的 hyperCa；未被腎臟清除
Hemodialysis min during Rx
- If other measures ineffective or contraindicated