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Furosemide can be used to treat hypercalcemia as it induces caliuresis (excreting calcium in the urine). Standard practice of adequate rehydration and electrolyte monitoring should be used to avoid alkalosis and renal insufficiency. [15] If kidney failure is advanced then treatment for that is required, namely chronic dialysis. [14]
Primary treatment of hypercalcemia consists of administering IV fluids. [3] If the hypercalcemia is severe and/or associated with cancer, it may be treated with bisphosphonates. [3] [14] For very severe cases, hemodialysis may be considered for rapid removal of calcium from the blood. [3] [14]
Sodium cellulose phosphate is a drug used to treat hypercalcemia and hypercalciuria. It has been investigating for the prevention of kidney stones, [1] [2] but with limited efficacy. [3] This compound is an ion-exchange resin that can not be absorbed by the body. However, it can be used to restore the normal intestinal calcium absorption.
Hypercalcemia of malignancy may also occur due to tumor production of vitamin D or parathyroid hormone. These causes are rare and constitute about 1% of all causes of hypercalcemia of malignancy. [22] Hypercalcemia of malignancy usually portends a poor prognosis, and the medial survival is 25–52 days of its development. [22]
Calcium gluconate side effects include nausea, constipation, and upset stomach. Rapid intravenous injections of calcium gluconate may cause hypercalcemia, which can result in vasodilation, cardiac arrhythmias, decreased blood pressure, and bradycardia. Extravasation of calcium gluconate can lead to cellulitis.
Idiopathic hypercalcinuria (IH) is a condition including an excessive urinary calcium level with a normal blood calcium level resulting from no underlying cause. [1] IH has become the most common cause of hypercalciuria and is the most serious metabolic risk factor for developing nephrolithiasis. [1]
Persons with nephrogenic diabetes insipidus must consume enough fluids to equal the amount of urine produced. Any underlying cause such as high blood calcium must be corrected to treat nephrogenic diabetes insipidus. The first line of treatment is hydrochlorothiazide and amiloride. [10] Patients may also consider a low-salt and low-protein diet.
Medications to treat the toxic effects include: intravenous fluids, calcium gluconate, glucagon, high dose insulin, vasopressors and lipid emulsion. [1] [2] Extracorporeal membrane oxygenation may also be an option. [1] More than ten thousand cases of calcium channel blocker toxicity were reported in the United States in 2010. [2]