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MS 2 - Unit 5 > "Pharmacology Parathyroid Jennifer Kelly" > Flashcards

"Pharmacology Parathyroid Jennifer Kelly" Flashcards

1
Q

What states promote the reabsorption of phosphate?

A

Phosphate depletion
Hypocalcemia
Hypoparathyroidism

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2
Q

What states promote the excretion of phosphate?

A 
PTH
PTHrP
Hypercalcemia
Hypokalemia
Hypomagnesemia
Calcitonin
Glucocorticoids
Diuretics
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3
Q

What drugs inhibit magnesium reabsorption in the Loop of Henle?

A

Furosemide

Cisplatin

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4
Q

How does vitamin D work to maintain calcium homeostasis?

A

Increases intestinal absorption of dietary calcium and stimulating bone cells to become osteoclasts

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5
Q

What are the most common causes of hypercalcemia?

A

Hyperparathyroidism

Malignancy

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6
Q

Why can granulomatous diseases such as sarcoidosis cause hypercalcemia?

A

These diseases increase the conversion of active vitamin D (25–>1,25) which increases osteoclast activity.

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7
Q

What is the most common cause of primary hyperparathyroidism?

A

Benign, solitary adenoma

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8
Q

What labwork is commonly found in primary hyperparathyroidism?

A

High or normal PTH
Elevated urine calcium
Elevated serum calcium
Low phosphorous (may see)

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9
Q

Class: Cinacalcet

A

Calcimimetic

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10
Q

MOA: Cinacalcet

A

Reduces PTH and serum calcium levels (alters function of calcium receptor)

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11
Q

Uses: Cinacalcet

A

Secondary hyperparathyroidism from renal disease; parathyroid carcinoma;
hypercalcemia in primary hyperparathyroidism not treatable by surgery

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12
Q

Side effects: Cinacalcet

A

Vision changes, palpitations, dizziness, chest pains, headache

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13
Q

What is milk alkali syndrome?

A

Excessive use of OTC calcium such as Tums

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14
Q

Lithium can have what effects on calcium levels?

A

Lithium can increase PTH levels and increase parathyroid gland mass

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15
Q

Thiazides have what effect on calcium?

A

They increase serum calcium by lowering excretion

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16
Q

Class: Pamidronate

A

Bisphosphonate

17
Q

MOA: Pamidronate

A

Reduce osteoclastic bone resorption

18
Q

Uses: Pamidronate

A

Hypercalcemia of malignancy;
Paget’s disease of bone;
prevention of fractures in osteogenesis imperfecta

19
Q

Side effects: Pamidronate

A

Fever

Flu-like symptoms

20
Q

Class: Zoledronic acid

A

Bisphosphonate

21
Q

MOA: Zoledronic acid

A

Reduce osteoclastic bone resorption

22
Q

Uses: Zoledronic acid

A

Hypercalcemia of malignancy;
Paget’s disease of bone;
prevention of fractures in osteogenesis imperfecta

23
Q

Side effects: Zoledronic acid

A

Fever

Flu-like symptoms

24
Q

How are bisphosphonates administered?

A

IV, so bypasses GI tract

Takes several days to lower serum calcium

25
Q

How do you prevent volume overload and promote calcium excretion in the treatment of hypercalcemia?

A

Give a loop diuretic such as fursemide, bumetanide, torsemide, ethacrynic acid

26
Q

How does renal disease cause secondary hyperparathyroidism?

A

Phosphate retention, and lack of 1-alpha hydroxylase activity in the failing kidney, resulting in a 1,25 deficiency. At high concentrations, phosphate directly stimulates PTH secretion

27
Q

How is parathyroidism secondary to renal disease treated?

A

Low phosphate diet
Phosphate binders
vitamin D supplementation
Dialysis

28
Q

What is tertiary hypoparathyroidism?

A

Parathyroid glands become autonomous after prolonged secondary parathyroidism
Gland ends up oversecreting, so patients resemble those with primary parathyroidism
Serum calcium is high

29
Q

In what endocrinologic condition would you see a prolonged QT interval?

A

Hypocalcemia

A shortened QT interval would be seen in hypercalcemia

30
Q

Class:
Calcitriol;
Paracalcitol;
Doxercalciferol

A

Vitamin D analogs

31
Q

MOA: Calcitriol;
Paracalcitol;
Doxercalciferol

A

Binds to VDR and elevates serum calcium levels

32
Q

Uses: Calcitriol;
Paracalcitol;
Doxercalciferol

A

Secondary hyperparathyroidism from renal disease

MS 2 - Unit 5 (21 decks)

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