How do bisphosphonates work in hypercalcemia?

Bisphosphonates inhibit osteoclastic bone resorption and are effective in the treatment of hypercalcemia due to conditions causing increased bone resorption and malignancy-related hypercalcemia. Pamidronate and etidronate can be given intravenously, while risedronate and alendronate may be effective as oral therapy.

How do bisphosphonates lower calcium?

By inhibiting bone resorption, bisphosphonates reduce calcium efflux from bone into the circulation, leading to the development of hypocalcemia.

Why does bed rest cause hypercalcemia?

Within just a few days of immobility, bone demineralisation leads to loss of calcium from bone and, therefore, a rise in plasma calcium levels; after five weeks of bedrest there is a measurable increase of up to 50ml in the amount of calcium excreted in the urine (Zerwekh et al, 2007).

How does bisphosphonate therapy work?

Bisphosphonates work by slowing down the cells which break down bone (osteoclasts). Therefore they slow down bone loss, allowing the bone building cells (osteoblasts) to work more effectively. They can help to strengthen bone and help to prevent it getting any weaker.

What is hypercalcemia and how is it treated?

Hypercalcemia has been reported with theophylline usage for chronic obstructive pulmonary disease or asthma and appears reversible with cessation of therapy or amenable to treatment with beta – adrenergic antagonists (232). Aluminum Intoxication

What is the approach to the history and physical examination of hypercalcemia?

The approach to the history and physical examination of the hypercalcemic patient should focus on the signs and symptoms which are relevant to hypercalcemia, and the signs and symptoms which are relevant to the causal disorder.

What is the relationship between hypercalcemia and malignancy?

Hypercalcemia in association with malignancy is generally more acute and severe than in association with primary hyperparathyroidism.

What causes hypercalcemia in acute promyelocytic leukaemia?

Suzumiya J, Asahara F, Katakami H, Kimuran N, Hisano S, Okumura M, Ohno R. Hypercalcemia caused by all trans-retinoic acid treatment of acute promyelocytic leukaemia: case report. Eur. J. Haematol. 1994;53:126–127.