hypercalcemia of malignancy management

fluids and lasix
bisphosphonates (zoledronic acid, pamidronate): most effective agents. Inhibit bone resorption. Can lower Ca to normal in a few days.
denosumab: considered alternative to zoledronic acid. Better for kidney failure patients
calcitonin: increases kidney excretion and decrease bone resorption. Works in several hours¹
steroids: good for stopping peripheral conversion of vitamin D (lymphoma, myeloma). Inhibits osteoclastic absorption
dialysis: can get away without most of the time unless there’s significant AKI, CHF, neurologic impairment²

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