drugs for hyperparathyroidism Flashcards
actions of the vitamin D analogs
to inhibit PTH release in patients with evidence of bone disease
CALCIUM AND PHOS HAVE TO BE AT GOAL BEFORE STARTING: DO NOT WANT TO THROW OFF THE BALANCE
what drugs are the vitamin D analogs
calcitriol
paricalcitol
doxercalciferol
calcitriol effects
greatest effects on Ca and Phos levels
paricalcitol effects
LEAST effects on Ca and Phos levels
can start before they are at goal
doxercalciferol effects
similar to calcitriol effects
requires liver activation 25-hydroxylation
what are the actions of the calcimimetics
decrease PTH
decrease Ca
decreases Phos in dialysis, increases Phos not on dialysis
which drugs are the calcimimetics
cinacalcet
etecalcetide
cons of the calcimimetics
drug interactions- CYP
causes GI effects- nausea, vomiting
causes HYPOCALCEMIA
do NOT initiate if corrected Ca level is <8.4
which vitamin D supplements are used
D2- ergocalciferol
D3- cholecalciferol
vitamin D requires _____ for activation
1alpha-hydroxylase
actions of ergocalciferol and cholecalciferol
replaces 25-hydroxyvitamin D– the form that circulates in the body
drugs that can be used to manage hyperparathyroidism in CKD
phos binders (elevated phos stimulates PTH release)
vitamin D analogs (need Ca and Phos at goal)
calcimimetics (causing hypocalcemia, don’t start <8.4. but considered first line agent if Ca is normal)
vitamin D supplementation
____ parathyroidism results in _____
hyperparathyroidism
stimulates bone turnover from osteoclasts
leads to bone disease, osteomalacia
1,25-dihydroxyvitamin D levels in CKD are _____
decreased (lack of 1 alpha-hydroxylase activity)
