UMEM Educational Pearls

Title: Treatment of Hyperparathyroidism and Hypercalcemia

Category: Endocrine

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.