Electrolyte Abnormalities

Question 1

What is the Tx for Hypercalcemia?

Answer 1

Increased Ca, Increased PTH, Dec phosphate

NS + Calcitonin + Bisphosphonate

Give NS + Calcitonin (use Salmon calcitonin only up to 48) combine with bisphosphonates (inhibits calcium release by blocking osteoclasts; not as much calcium coming off the bones)

IV Pamidronate or zoledronic acid (ZA) are the bisphosphonates ((ZA IS MORE POTENT)

Question 2

If vitamin D intoxication occurs; what therapy would you prescribe?

Answer 2

Steroids (I.e. Prednisone 20-40mg/d within 2-5 days)

Question 3

If parathyroid disease is present what drug therapy would you prescribe?

Answer 3

Calcimimetics

Question 4

What is the treatment for Diabetes Insipidus?

Answer 4

Desmopressin (dDAVP) subQ preferred

Question 5

How would you definitively Dx a PT with Hyponatremia?

Answer 5

<135 meq/L Serum Sodium
Peripheral edema
“Water intox” (hypervolemic hyponatremia) or SIADH (will be euvolemic hyponatremia)

Question 6

What is the treatment for a PT that has free water retention and super concentrated urine?

Answer 6

Syndrome of SIADH

H2O RESTRICTION + Demeclocycline
~~Blocks ADH

Question 7

What is an important factor to keep in mind when correcting Hyponatremic patients?

Answer 7

10 meq/L per day

THIS WILL ENSURE NO OSMOTIC DEMYELINATION SYNDROME