Hypercalcemia tx

• Acute, loop diuretics i.e lasix to promote elimination of excess calcium
• Acute, Calcitonin will promote the uptake of calcium in bones and rapidly lower serum Ca level; 
• slows the release of calcium from bones into bloodstream, thereby keeping blood levels of calcium to a minimum
• Biphosphonate ( pamidronate, etidronate), inhibit bone resorption
• IV plincamycin (mithramycin), inhibit bone resorption
• Sodium phosphate or Potassium phosphate; increase in phosphate = decrease in calcium
• Glucocorticoids (cortisone), compete with vitamin D and low calcium diet to decrease GI absorption of calcium, inhibit bone resorption and increase urinary excretion of calcium
• Isotonic IV, to replace sodium and restore vascular volume. 
• Sodium excretion is accompanied by calcium.
• Watch out for hypervolemia because of isotonic IV.