Pseudohypoparathyroidism medical therapy: Difference between revisions
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**An additional dose of 100 mg/hr of [[elemental calcium]] can be infused if symptoms do not resolve, with close monitoring of [[calcium]] levels | **An additional dose of 100 mg/hr of [[elemental calcium]] can be infused if symptoms do not resolve, with close monitoring of [[calcium]] levels | ||
**Cardiac monitoring may help to guide therapy as rapid infusion of [[calcium]] can cause cardiac conduction defects; | **Cardiac monitoring may help to guide therapy as rapid infusion of [[calcium]] can cause cardiac conduction defects; | ||
* | **Preferred regimen (2):[[Parenteral|Parentera]]<nowiki/>l formulations available are [[calcium chloride]] and [[calcium gluconate|calcium]] [[calcium gluconate|gluconate]] 100 mg of over 10 to 20 minute | ||
*For [[neonates]], [[infants]], and [[children]] | *** <nowiki/>10% [[calcium chloride]] a 10-mL ampule contains 360 mg of [[elemental calcium]] | ||
*** 10% [[calcium gluconate]] 10-mL ampule contains 93 mg of elemental [[calcium]]. | |||
*'''''For [[neonates]], [[infants]], and [[children]]''''' | |||
** Preferred regimen (1):10% [[calcium gluconate]] 0.5-1 mL/kg of administered over 5 minutes. | |||
Revision as of 20:11, 29 September 2017
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Pseudohypoparathyroidism Microchapters |
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Differentiating Pseudohypoparathyroidism from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
The mainstay of treatment for pseudohypoparathyroidism is oral calcium and 1alpha-hydroxylated vitamin D metabolites, such as calcitriol. Other forms of Vitamin D cannot be used as parathyroid hormone resistance in the proximal tubule decreases the efficiency of production of 1,25(OH)2 vitamin D from 25-hydroxyvitamin D.Intravenous calcium is recommended for all patients who develop severe symptomatic hypocalcemia.
Medical Therapy
- The mainstay of treatment for pseudohypoparathyroidism is oral calcium and 1alpha-hydroxylated vitamin D metabolites, such as calcitriol. Other forms of Vitamin D cannot be used as parathyroid hormone resistance in the proximal tubule decreases the efficiency of production of 1,25(OH)2 vitamin D from 25-hydroxyvitamin D.Intravenous calcium is recommended for all patients who develop severe symptomatic hypocalcemia.
- The majority of cases of pseudohypoparathyroidism are self-limited and require only supportive care.
- The goal is to maintain serum calcium within the normal range to prevent hypercalciuria and to maintain parathyroid hormone levels within reference range which helps prevent bone remodeling and hyperparathyroid bone disease that can result from elevated parathyroid hormone level.
- Intravenous calcium is recommended for all patients who develop severe symptomatic hypocalcemia.
- Adult
- Preferred regimen (1):elemental calcium (either calcium chloride or calcium gluconate) 100 mg of over 10 to 20 minute
- An additional dose of 100 mg/hr of elemental calcium can be infused if symptoms do not resolve, with close monitoring of calcium levels
- Cardiac monitoring may help to guide therapy as rapid infusion of calcium can cause cardiac conduction defects;
- Preferred regimen (2):Parenteral formulations available are calcium chloride and calcium gluconate 100 mg of over 10 to 20 minute
- 10% calcium chloride a 10-mL ampule contains 360 mg of elemental calcium
- 10% calcium gluconate 10-mL ampule contains 93 mg of elemental calcium.
- For neonates, infants, and children
- Preferred regimen (1):10% calcium gluconate 0.5-1 mL/kg of administered over 5 minutes.