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PHRM 864 > Bone Modifying > Flashcards

Bone Modifying Flashcards

1
Q

pathophysiology of hypercalcemia metastatis

A

increased PTH
increasedcalcitriol
increased resporption
decreased elimination
bone metastasis

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2
Q

mild hypercalcemia level

A

10-12

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3
Q

moderate hypercalcemia level

A

12-14

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4
Q

severe hypercalcemia level

A

14+

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5
Q

mild hypercalcemia symptoms

A

polyuria
polydypsia

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6
Q

moderate hypercalcemia symptoms

A

dehydration
confusion
N/V
lethargu

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7
Q

severe hypercalcemia sx

A

decreased GFR
seizures
arrythmias

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8
Q

normal calcium level

A

8.5-10

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9
Q

corrected calcium equation

A

serum calcium + 0.8 (4-serum albumin)

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10
Q

mild hypercalcemia 10-12 treatment

A

no sx: hydration
moderate sx: 200-400 ml/hr NS + bisphosphonate
(either zolendronic acid or pamidronate)

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11
Q

moderate hypercalcemia tx 12-14

A

hydration
zolendronic acid

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12
Q

severe hypercalcemia tx 14+

A

hydration - 200ml/hr
zolendronic acid or pamidronate
calcitonin 3rd line

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13
Q

2nd line if refractory hypercalcemia

A

denosumab

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14
Q

chronic hypercalcemia tx

A

zolendronic acid
pamidronate
MONTHLY

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15
Q

what do bisphosphonates do

A

decrease osteoclast activity
decrease bone resorption
build up the bone

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16
Q

cancers with affinity to bone

A

breast
prostate
myeloma
lung
kidney

17
Q

treatment of bony mets overview

A

radiation
radioisotopes
bisphosphonates

18
Q

bisphosphonates in bony mets with consdierations

A

zolendronic acid - quicker , more expensive
pamidronate - slower, cheaper
need to renal adjust!!

19
Q

for what disease state do we renally adjust bisphosphonates

A

bony mets (NOT Hypercalcemia)

20
Q

supplments for pts taking bisphosphonates

A

vit D and calcium

21
Q

denosumab renal considerations

A

no renal adjustments

22
Q

refractory to bisphosphonates in bony mets tx

A

denosumab

23
Q

adverse effects of bisphosphonates

A

osteonecrosis of jaw
hypocalcemia

24
Q

denosumab side effects

A

hypocalcemia
need vit d and ca supplement

PHRM 864 (23 decks)

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