27.3 Calcium Preparations, Vitamin D, Bisphosphonates, Calcimimetics, and Peptide Hormones

Calcium and vitamin D are crucial for maintaining healthy bones and normal bodily functions. When the body can't regulate these on its own, like in hypoparathyroidism, medications step in to help. These drugs work together to keep calcium levels in check and prevent serious complications.

From calcium supplements to hormone replacements, there's a range of treatments available. Each has its own way of working and potential side effects. It's important for nurses to understand these medications to provide the best care and education to patients managing this condition.

Calcium Preparations, Vitamin D, and Other Drugs for Hypoparathyroidism

Calcium preparations, vitamin D, bisphosphonates, calcimimetics, peptide hormones characteristics

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• Calcium preparations provide oral supplements (calcium carbonate, calcium citrate) increase serum calcium levels potential side effects include constipation hypercalcemia
• Vitamin D fat-soluble vitamin (calcitriol, ergocalciferol) enhances calcium absorption increases serum calcium phosphate levels potential side effects hypercalcemia hypercalciuria
• Bisphosphonates antiresorptive agents (alendronate, risedronate) inhibit osteoclast activity prevent bone loss fractures potential side effects esophageal irritation osteonecrosis of the jaw
• Calcimimetics allosteric activators (cinacalcet) of calcium-sensing receptors lower parathyroid hormone (PTH) secretion serum calcium levels potential side effects nausea vomiting hypocalcemia
• Peptide hormones recombinant forms of PTH (teriparatide, parathyroid hormone) stimulate bone formation increase serum calcium levels potential side effects hypercalcemia hypercalciuria rare osteosarcoma

Indications, mechanisms of action, potential side effects hypoparathyroidism drugs

• Indications treat hypocalcemia due to hypoparathyroidism maintain normal serum calcium phosphate levels prevent complications (tetany, seizures, arrhythmias, osteoporosis)
• Mechanisms of action calcium preparations provide elemental calcium increase serum levels vitamin D enhances intestinal absorption renal reabsorption of calcium bisphosphonates inhibit bone resorption reduce calcium loss calcimimetics activate calcium-sensing receptors lower PTH secretion peptide hormones mimic endogenous PTH stimulate bone formation calcium reabsorption
• Potential side effects hypercalcemia (calcium preparations, vitamin D, peptide hormones) hypocalcemia (calcimimetics) gastrointestinal disturbances (constipation, nausea, vomiting) renal complications (hypercalciuria, nephrolithiasis) bone-related issues (osteonecrosis of the jaw with bisphosphonates, osteosarcoma with peptide hormones)

Nursing considerations administering hypoparathyroidism medications monitoring parameters potential drug interactions

• Monitoring parameters serum calcium, phosphate, magnesium levels renal function (creatinine, BUN) bone mineral density (BMD) for long-term therapy signs of hypercalcemia or hypocalcemia
• Potential drug interactions calcium preparations decreased absorption with bisphosphonates, tetracyclines, quinolones vitamin D enhanced toxicity with thiazide diuretics, calcium supplements bisphosphonates decreased absorption with calcium, iron, magnesium supplements calcimimetics increased risk of hypocalcemia with bisphosphonates, denosumab
• Nursing considerations administer calcium preparations with meals for better absorption encourage adequate hydration prevent renal complications monitor for signs of hypercalcemia (confusion, fatigue, constipation) or hypocalcemia (paresthesia, muscle cramps, seizures) educate patients on proper administration potential side effects

Patient education plan hypoparathyroidism medications proper usage dietary considerations signs of complications

• Proper usage follow prescribed dosage administration schedule take calcium preparations with meals for optimal absorption maintain adequate hydration prevent renal complications use bisphosphonates as directed (on an empty stomach, upright posture)
• Dietary considerations consume a balanced diet with adequate calcium vitamin D avoid excessive intake of foods high in phosphates (processed meats, soft drinks) limit alcohol consumption as it can interfere with bone metabolism
• Signs of complications hypercalcemia fatigue confusion constipation abdominal pain excessive thirst hypocalcemia paresthesia muscle cramps tetany seizures arrhythmias renal issues flank pain hematuria increased urinary frequency bone-related problems jaw pain delayed healing after dental procedures
• Follow-up care attend regular check-ups monitor serum calcium phosphate magnesium levels undergo periodic BMD scans assess bone health report any adverse effects or signs of complications to healthcare provider