module 16 phosphate binders, Ca, Vit. D Flashcards
oral phosphate binder meds
calcium carbonate
calcium acetate
selvelamer
calcium carbonate/acetate MOA
binds to dietary phosphate preventing absorption
calcium carbonate/acetate use
CKD related hyperparathyroidism
hypocalcemia
calcium carbonate/acetate AE
iatrogenic hypercalcemia
- inc. risk with Vit. D supplementation
inc. vascular calcification risk
calcium carbonate/acetate admin
with meals
calcium carbonate/acetate monitoring
Ca
sevelamer MOA
binds to dietary phosphate preventing absorption
sevelamer use
CKD related hyperparathyroidism
hypercalcemia
sevelamer AE
sevelamer HCL: dec bicarb -> metabolic acidosis
sevelamer carbonate: buffered to avoid metabolic acidosis
sevelamer EDU
also binds bile acid -> dec. cholesterol
lanthanum carbonate MOA
rare earth element with high phosphate binding
-> inhibits dietary absorption
lanthanum carbonate use
CKD related hyperparathyroidism
hypercalcemia
vitamin D and analog meds
calcitriol
doxecalciferol
paricalcitol
paricalcitol
synthetic analog of Vit. D
doxecalciferol
activated in liver
Vitamin D and analogs use
CKD related hyperparathyroidism
vitamin D and analog AE
hypercalcemia
calcimimetic med
cinacalcet
cinacalcet MOA
binds to Ca sensing Rc
- > inc. sensitivity to Ca
- > activation at lower Ca level
- > dec. PTH synthesis and secretion
cinacalcet use
secondary hyperparathyroidism
hypercalcemia r/t parathyroid carcinoma
calcium meds
IV: - Ca gluconate - Ca chloride Oral: - Ca citrate - Ca carbonate - Ca phosphate - Ca lactate
calcium use
IV: severe hypocalcemia
oral:
- hypoparathyroidism
- osteoporosis
calcium admin
Ca citrate: best absorbed Ca carbonate: - low cost - antacid properties - absorbed best with food
calcium AE
constipation
kidney stones
Vitamin D meds
cholecalciferol D3
Ergocalciferol D2
Vitamin D use
hypoparathyroidism
rickets
osteomalacia
osteoporosis
vitamin D EDU
not active form has to be converted by kidney
- cholecalciferol
- ergocalciferol