Diagnosis + Treatment of Disease- Ca Metabolism Flashcards
Name 3 disorders of the parathyroid gland
- Primary HYPOparathyroidism
- Primary HYPERparathyroidism
- Secondary HYPERparathyroidism
What is the difference b/w primary + secondary HYPERparathyroidism?
Primary = caused by function PTH tumour Secondary = caused by nutrition/ renal factor
What blood tests can be used to detect disturbances of Ca metabolism?
- Total serum Ca = ionised Ca + protein bound, normally 50:50
- PTH
What factors may affect protein-bound Ca?
blood albumin concentration, acid-base status
What blood test results would be expected from an animal w/ primary HYPERparathyroidism?
Increased blood Ca due to increased PTH caused by functional tumour
What blood results would be expected from an animal w/ primary HYPOparathyroidism?
decreased blood Ca due to decreased PTH
What methods could be used to treat disturbances of Ca metabolism?
Ca replacement therapy w/ Ca salts, Vitamin D preparations
Name 4 Ca salts that could be used in Ca replacement therapy
- Ca gluconate
- Ca carbonate (insoluble)
- Ca chloride
- Ca borogluconate
Describe the pharmokinetics oral administration of Ca
Absorption from SI
Vit D3, PTH, acidic pH facilitate absorption
Dietary fibre, phytates, steatorrhea + uraemia interfere w/ absorption
What method is more effective to correct Ca metabolism than replacement therapy?
Increasing dietary Ca + administering Vitamin D3
What adverse effects may occur after administering Ca?
Hypercalcaemia- detrimental w/ cardiac/ renal disease
Rapid IV effects on heart- arrest/ arrythmias
What is Vitamin D3?
range of hormones that alter Ca + P metabolism
What is Vitamin D3 used to treat?
Iatrogenic hypoPTHism after thyroidectomy + immune mediated hypoPTHism
Renal secondary hyperPTHism
How can renal disease cause secondary hyperPTHism?
Increase of inorganic P increases release of PTH by 3 mechanisms:
- direct effect on PTH gland to promote release
- indirect effect by decreasing calcitriol production
- formation of complex w/ ionised Ca
Explain the pharmokinetics of Vitamin D3 administration
Oral administration- good GI absorption
Protein bound by vitamin D- binding globulin
Excreted in faeces
