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16 Cards in this Set
- Front
- Back
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How do calcium channel blockers interact with calcium?
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CCBs effects may be diminished. Response should be monitored.
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How does levothyroxine interact with calcium?
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Calcium carbonate (and possibly other calcium salts) may decrease T4 absorption. Calcium doses should be seperated from levothyroxine by at least 4 hours.
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How do thiazide diuretics interact with calcium?
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Thiazide diuretics can cause hypercalcemia. High doses of calcium with thiazide diuretics may result in milk-alkali syndrome and hypercalcemia.
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How does digotoxin interact with calcium?
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Calcium may potentiate digoxin toxicity.
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How do proton pump inhibitors or H2 blockers interact with calcium?
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PPI and H2 blockers cause calcium carbonate to be poorly absorbed.
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How does digitalis interact with IV calcium?
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Patients taking digitalis may have an increased sensitivity to intravenous calcium. Rapid administration could result in arrhythmias so that intravenous calcium administration should be carefully monitored.
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What is the best method to correct vitamin D deficiency and how should one monitor the response?
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50,000 IU of vitamin D once a week for 8 weeks raises the circulating concentration of 25(OH)D into the normal range. Maintain on 800 to 1000 IU/day.
Serum concentrations of 25OHD are helpful for assessing vitamin D status in individuals. |
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How do loop and thiazide diuretics effect calcium excretion?
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Loop diuretics increase calcium excretion while thiazide diuretics have a hypocalciuric effect that can protect against calcium stones and possible bone loss.
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What is teraparatide and when is it indicated?
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Teraparatide is recombinant human PTH containing a 34-amino acid sequence which is identical to the N-terminal portion of PTH. It stimulates osteoblast function, increases GI calcium absorption, and increases renal tubular reabsorption of calcium.
Teraparatide is indicated for osteoporosis. Teraparatide increases MBD and decreases the risk of vertebral fractures by 65% and nonvertebral fractures by 53%. |
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What are the bisphosphates?
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The bisphosphates inhibit osteoclastic bone resorption by attaching to bone surfaces undergoing active resorption. They also decrease osteoclast numbers.
Alendronate, risedronate, irbandronate, etidronate, tiludronate, pamidronate, and zoledronic acid |
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What are the major side effects of the bisphosphates?
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GI - Abdominal pain, dyspepsia, nausea, acid reflux, esophagitis, esophageal erosions
Hypocalcemia Ocular - pain. blurred vision, conjunctivitis, uveitis, and slceritis (all rare) Musculoskeletal pain - rare Osteonecrosis of the jaw (avascular necrosis) - associated with chronic IV therapy |
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What are alendronate's indications?
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po
Prevention and treatment of osteoporosis in postmenopausal women, osteoporosis in males, prevention of osteoporosis secondary to glucocorticoids, and Paget's disease of bone. |
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What are risedronate's indications?
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po
Prevention and treatment of osteoporosis in postmenopausal women, osteoporosis in males, prevention of osteoporosis secondary to glucocorticoids, and Paget's disease of bone. |
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What are ibandronate's indications?
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po
Prevention and treatment of postmenopausal osteoporosis. |
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What are pamidronate's indications?
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IV
Indicated for hypercalcemia of malignancy, osteolytic bone lesions with multiple myeloma and breast cancer, and Paget's disease. Has been associated with the development of nephrotic syndrome. |
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What are zoledronic acid's indications?
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Indicated for the treatment of hypercalcemia of malignancy, multiple myeloma or metastatic bone lesions from solid tumors. Recently approved for treatment of osteoporosis. Has been associated with renal impairment.
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