Pediatric Hyperparathyroidism Medication

Updated: Apr 17, 2017
  • Author: Edna E Mancilla, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Medication

Isotonic crystalloids

Class Summary

Sodium chloride 0.9% fluid is used to supply intravenous hydration to replace fluids lost by emesis for patients with acute hypercalcemia of any etiology.

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Bisphosphonates

Class Summary

Bisphosphonates are antiresorptive agents that are used to help preserve bone mass. They are available in oral and parenteral forms. The inhibition of bone resorption produces a hypocalcemic effect. These agents are used in the management of conditions associated with increased bone resorption (eg, osteoporosis, Paget disease, management of hypercalcemia [especially that associated with malignancy]).

In case of acute hypercalcemia with vomiting, parenteral therapy is recommended. By reducing bone resorption, a calcium-lowering effect in the blood may occur.

Pamidronate (Aredia)

IV bisphosphonate that acts as an antiresorptive agent. Inhibits normal and abnormal bone resorption. Appears to inhibit bone resorption without inhibiting bone formation and mineralization. Currently accepted uses include the treatment of hypercalcemia associated with neoplasms and metastases as well as for treatment of Paget disease. This category of drugs is not approved for the treatment of hypercalcemia secondary to hyperparathyroidism; however, in practice, can be used for this as well as in the management of postmenopausal osteoporosis. Now being used in pediatrics to treat osteogenesis imperfecta and idiopathic juvenile osteoporosis. Preliminary study results on its use to prevent bone loss following severe burns appear promising.

Zoledronate

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Calcimimetic Agent

Class Summary

These agents are allosteric modulators of the CASR and thus reduce PTH levels

Cinacalcet (Sensipar)

Directly lowers intact parathyroid hormone (iPTH) levels by increasing sensitivity of calcium sensing receptor on chief cell of parathyroid gland to extracellular calcium. Also results in concomitant serum calcium decrease. Indicated for secondary hyperparathyroidism in patients with chronic kidney disease on dialysis.

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1,25 OH2 Vitamin D

Calcitriol

Calcitriol is used for post -surgical hypoparathyroidism in conjunction with calcium supplements.

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