Hypercalcemia treatment

Q: Bisphosphonates should be used very early in the treatment of symptomatic patients with hypercalcemia?

A) True

B) False

Answer: B

Although bisphosphonates are more effective than calcitonin and saline for symptomatic patients with hypercalcemia, it takes 2-4 days to have a clinical effect. This requires them to be given in the early phase of hypercalcemia in combination with saline and/or calcitonin.

On the contrary, due to receptor downregulation, calcitonin loses its efficacy after 48 hours. 

#electrolytes

#endocrinology

References:

1. Turner JJO. Hypercalcaemia - presentation and management . Clin Med (Lond). 2017 Jun;17(3):270-273. doi: 10.7861/clinmedicine.17-3-270. PMID: 28572230; PMCID: PMC6297576.

2. Basso SM, Lumachi F, Nascimben F, Luisetto G, Camozzi V. Treatment of acute hypercalcemia. Med Chem. 2012 Jul;8(4):564-8. doi: 10.2174/157340612801216382. PMID: 22571195.