Hyperparathyroidism

Hydration and Diuresis:

Day1: infusion NS + Furosemide high dose

Maintenance: NS tablet + Furosemide

Bisphosphoante:

decrease BMD but not Calcium or PTH levels

Calcitonin:

BlockPTH bone resorption

fast onset

allergies and limiting effect

Plicamycin:

block hypercalemia of Vit. D and PTH bone resorption

Yes: Malignancy

Hepatic and renal toxicity

Gallium Nitrate:

inhibit bone resorption

nephrotoxicity, hypophosphatemia

Phosphate:

minimal effect

Yes: hypophosphatemia

slow onset, deposit in arteries

Glucocorticoids:

minimal effect

yes: sarcoidosis, vit D intoxication

slow onset

Vit D analogues:

supress PTH secretion

yes: secondary HPT (first line)