Calcium Flashcards
What are the functions of calcium
- Excitability of nerves and muscles
- essential for muscle contraction
- formation of teeth and bone
- necessary for release of some neural transmitters from storage vesicles of the nerve terminals
- acts as a second messenger
- necessary for blood coagulation
- maintains integrity and regulates permeability of cell membrane
What are the oral preparation of calcium
- Calcium gluconate
- calcium citrate
- calcium lactate
- calcium carbonate
What are the parental preparation of calcium
- IV calcium gluconate
- IV calcium chloride
Which form of calcium Causes tissue necrosis
IV calcium chloride
What is the therapeutic uses of calcium salts
- Corrects calcium deficiency in growing children, pregnant and lactating women
- postmenopausal osteoporosis
- rickets and osteomalacia along with vitamin D
- corticosteroid therapy along with vit. D
- remove parathyroid tumour used for the treatment of tetany
- used as an antacid
- useful in treating urticaria and dermatoses
What are the signs of acute hypo parathyroidism
- Hypocalcaemia
- tetany
- carpopedal spasm
- laryngospasm
- tingling of lips, hands, muscles
- convulsions
What are the signs of chronic hypoparathyroidism
- Loss of hair
- Brittle fingernails
- caries of teeth
- cataract
- anxiety and depression
What is the treatment of acute hypoparathyroidism attack or hypoparathyroid Tetany
- 10% calcium gluconate 10 to 20 ML given IV slowly
- oral calcium salts
What is the treatment of chronic hypo parathyroidism
- Vitamin D2 (ergocalciferol)
- oral calcium salts
What is the treatment of parathyroid tumour and secondary hyperparathyroidism due to renal disease
Cinacalcet
What is the mechanism of action of cinacalet
- Decreases PTH secretion decreases serum calcium levels
What is the use of teriparatide
Treatment of osteoporosis By stimulating bone formation and improves bone mineral density
What are the preparations of calcitonin
- Procaine calcitonin
- synthetic salmon calcitonin
- synthetic human calcitonin
What is the therapeutic uses of calcitonin
- Hypercalcaemic states
- Paget’s disease of bone
- Postmenopausal osteoporosis and corticosteroid induced osteoporosis
Describe the steps of vitamin D reproduction using sunlight
- 7-dehydroxycholesterol
UV light - Cholecalciferol
Liver - 25-hydroxycholecalciferol
Kidney - 1-alpha, 25-Dihydroxycholecalciferol
Describe the steps of vitamin D2 production without sunlight
- Ergocalciferol
liver - 25 – hydroxyergocalciferol
kidney - 1- alpha, 25 – dihydroxyergocalciferol
What are the functions of vitamin D
- Promotes Absorption of calcium and phosphate from the gut
- Promotes reabsorption of calcium and phosphate in renal tubules
- increases reabsorption of calcium and phosphate from bone
- Mineralization of bone
What happens of hypercalcaemia persists
Calcium salts deposit in the kidney resulting in renal failure in Renal stones
What are the preparation of vitamin D
- Ergocalciferol
- Cholecalciferol
- Calcitriol
- Alfacalcidol
- Dihydrotachysterol
- Calcipotriol
What are the therapeutic uses of vitamin D
- Prevention and treatment of nutritional rickets and osteomalacia
- vitamin D resistant rickets and osteomalacia
- Vitamin D dependent rickets
- Renal rickets
- hypoparathyroidism
- vitamin D for postmenopausal osteoporosis
- treatment of psoriasis
What are bisophosphonates
Analogues of pyrophosphate
Name bisphosphonates
- Etidronate
- Alendronate
- Pamidronate
- Zoledronate
- Risedronate
What is the Mechanism of action of bizphosphonates
- Have infinity for Calcium in the bone, and promote osteoclast apoptosis
- Interfere with mevalonate Pathway of cholesterol synthesis required for normal function of osteoclasts
What are the uses of bisphosphonates
- Paget’s disease
- Prevention and treatment of postmenopausal osteoporosis
- prevent corticosteroid induced osteoporosis
- hypercalcaemia of malignancy
- control hypercalcaemia and hyperparathyroidism
- relieve pain of lytic bone lesions
Which drug is the most potent and drug of choice for malignant Hypercalcaemia
Zoledronate
What are the adverse effects bisphosphonates
- Nausea, vomiting, diarrhea, fever
- heartburn
- esophagitis, peptic ulcer, myalgia
- Hypocalcaemia
- headache
- skin rash
- rarely osteonecrosis of the jaw
What are the drugs used for in Hypercalcaemia
- Bisphosphonates
- Mithromyrin
- glucocorticoids
- furosemide
What is strontium ranelate
Drug that inhibits phone reabsorption is useful in the treatment of osteoporosis