12> mg/dL
Hypercalcemia is defined as
kidney stones, bone pain, pancreatitis, constipation, polyuria, depressed/confused
Symptoms of Hypercalcemia? (6)
lithium, thiazides
Which medications can cause hypercalcemia? (2)
hyperparathyroidism
What is the most common cause of hypercalcemia?
positive allosteric modulators of CaSR on PTH gland; provide feedback to PT gland that calcium levels are appropriate and PTH secretion can slow
Calcimimetics MOA?
cinacalcet, etecalcetide
What are the calcimimetics? (2)
activate VDR to reduce PTH synthesis and promote calcium absorption/homeostasis
Vitamin D analogs MOA?
calcifediol, paricalcitol, doxercalciferol
What are the Vitamin D analogs? (3)
c
Which requires bioactivation in the liver?
a) calcimimetics
b) Paricalcitol
c) Doxercalciferol
d) calcitonin
recombinant analog of human calcitonin; counters PTH; increases osteoblast deposition of calcium
Calcitonin MOA?
correct dehydration, identify underlying disorders, reduce calcium absorption in GI, increase renal excretion of calcium, promote bone deposition, inhibit bone resorption
What are the strategies for treating Hypercalcemia? (6)
b
Which are used to reduce calcium absorption in the GI?
a) Denosumab
b) prednisone
c) calcitonin
d) -Nates
c
Which is used to increase renal excretion of calcium?
a) Denosumab
b) prednisone
c) calcitonin
d) -Nates
c
Which is used to promote bone deposition?
a) Denosumab
b) prednisone
c) calcitonin
d) -Nates
a,d
Which is used to inhibit bone resorption?
a) Denosumab
b) prednisone
c) calcitonin
d) -Nates
osteonecrosis of jaw, atypical femoral fracture, injection site reactoins
What are AE's of Denosumab & Bisphosphonates? (3)
d
Which have a half-life of over 100 hours?
a) Denosumab
b) prednisone
c) calcitonin
d) -Nates
inhibits farnesyl pyrophosphate; this reduces osteoclasts ability to bind to bone; also increases apoptosis
Bisphosphonates MOA?
bind to RANK-L receptor and reduce osteoclast maturation; decreasing the function/survival of osteoclasts
Denosumab MOA?
-nate suffix
What are the bisphosphonates?
d
Which is contraindicated in esophageal abnormalities?
a) Denosumab
b) prednisone
c) calcitonin
d) -Nates
Pamidronate, Alendronate, Zoledronate
Rank these in terms of potency. (least to most)
Zoledronate, Pamidronate, Alendronate