Mineral and Bone Disorders Flashcards
1
Q
Phosphate binders
A
- Lower phosphate levels
- Lowers PTH
2
Q
Calcium Salt Phosphate Binders Adverse Effects
A
- Hypercalcemia
- Constipation
3
Q
When do you correct calcium concentrations
A
-Serum albumin levels < 4
4
Q
Sevelamer
A
- Phosphate binder
- Free of metal ions
- Also lowers TC and LDLs
5
Q
Aluminum Salts
A
- High phosphate binding potency
- Adverse effect: aluminum toxicity, constipation, fecal impaction
- Avoid due to side effects
6
Q
Drug Interactions with Phosphate Binders
A
- Interfere with absorption of quinolones and levothyroxine
- Space administration timing
7
Q
Cinacalcet
A
- Binds to CaR and increases Ca sensitivity
- When Ca binds to the receptor it is activated
- PTH release is inhibited while CaR is activated
- Risk of HYPOcalcemia, avoid if Ca < 8.4mg/dL
- Inhibits CYP 2D6 (psych meds, and antiarrhythmic drugs)
8
Q
Cinacalcet Monitorin
A
- Ca and P levels after 1 week
- PTH 1 to 4 weeks of starting
- Ca < 7.5mg/dL HOLD
- May restart once Ca > 8mg/dL
9
Q
Monitoring
A
a) Stage 3-
- PTH q12mo
- Ca and P q12mo
b) Stage 4-
- PTH q3mo
- Ca and P q3mo
c) Stage 5
- PTH q3mo
- Ca and P q1mo
10
Q
Calcium Carbonate (OsCal, Tums)
A
- Inexpensive
- OTC
- 40% elemental Ca
- Wide variety available
11
Q
Calcium Acetate (PhosLo)
A
- Expensive
- Rx only
- 25% elemental Ca
- 1st line for hyperphosphotemia
12
Q
Calcium Citrate
A
- AVOID
- Increases absorption of aluminum, leading to toxicities
13
Q
Sucroferric Oxyhydroxide
A
- Velphoro
- Iron salt
14
Q
Ferric Citrate
A
- Auryxia
- Iron salt
15
Q
Ergocalciferol (D2)
A
- Inactive Vitamin D
- CKD 3 or 4
- Elevated PTH levels
- serum 25(OH) vitamin D <30ng/mL
