Lab Value


In patients with primary hyperparathyroidism, which of the following will cause worsening hypercalcemia?

In patients with primary hyperparathyroidism, medications that can cause increased calcium levels should be discontinued. Although certain diuretics (furosemide) can be used to decrease calcium levels, thiazides decrease the excretion of calcium, causing increased blood levels.

Intravenous hydration and furosemide will generally correct symptoms of hypercalcemia and decrease calcium levels in patients with hyperparathyroidism. Malignant hypercalcemia may be more difficult to manage and may require the use of bisphosphonates, which inhibit the action of osteoclasts and/or calcitonin. Calcitonin is a fairly poor hypercalcemic treatment agent but has a short time to onset of action and minimal adverse effects. Hemodialysis may also be used in refractory cases of hypercalcemia.