Exam 2 - Hypercalcemia/SREs Flashcards
In which type of cancer is HCM the most common?
lung cancer (35%)
S/Sx of moderate-severe hypercalcemia
lethargy and confusion
seizures
arrhythmias
corrected calcium =
serum Ca + 0.8 (4 - serum albumin)
severe hypercalcemia: Ca > ______ mg/dL
14
Moderate hypercalcemia treatment options
Hydration - will work quicker than Bisphosphonates
Bisphosphonates - zoledronic acid 4mg IV over 15mins
Severe hypercalcemia treatment options
HYDRATION!! (usually 200mL/hr)
Bisphosphonates
Calcitonin
What drug may be used for treatment refractory HCM?
Denosumab
Which agents are used for chronic HCM?
Bisphosphonates:
Zoledronic acid
Pamidronate
Which cancer patient populations are at higher risk for fracture?
- women with breast cancer -> especially on aromatase inhibitors, low BMI, history of fracture, smoker
- men with prostate cancer -> on ADT, smoker
Treatment options for bone metastases
- radiation (85% response rate)
- chemotherapy
- IV bone modifying agents: bisphosphonates
IV bisphosphonates (zoledronic acid and pamidronate) require ______ _______ ___________ when used for skeletal related events
renal dose adjustments
**not required when used for hypercalcemia
Bisphosphonates should be supplemented with…..
calcium
Pamidronate has a __________ infusion time than zoledronic acid
longer
Does denosumab require renal dose adjustments?
NO
Which formulation of denosumab is used for bone metastases from solid tumors?
Xgeva 120mg SQ every 4 weeks
