UMEM Educational Pearls

Category: Endocrine

Title: Treatment of Hyperparathyroidism and Hypercalcemia

Keywords: Hypercalcemia, Hyperparathyroidism (PubMed Search)

Posted: 9/5/2009 by Michael Bond, MD
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Medical Treatment of Hyperparathyroidism

  • Hyperthyroidism will typically only need to be treated in the Emergency Department when they present with Hypercalcemia. 
  • Outpatient management of hyperthyroidism consists of serial PTH measurements, Calcium, and Creatinine.
  • Hypercalcemia should be treated with normal saline hydration. 
    • Once the patient is determined to be euvolemic you can enhance diuresis and excretion of calcium by giving the patient furosemide. 
    • Remember hydrochlorathiazide can actually increase serum calcium by preventing its excretion.
    • This patients should receive 4-10 liters of normal saline in the first day.
    • You can also give bisphosphonates and calcitonin. 
    • For high calcium levels with mental status changes consider hemodialysis.