Calcium stones in pt with hypercalcemia

[Major0909]

hey quick question for you guys-

lets say a pt has recurrent calcium stones with hypercalcemia and youve given IVF/pain control and the question asks for your next treatment (ive seen this in a couple of places for Step 1 and 2)

I know you dont want to give loops (decrease body Ca but increase renal Ca) but what about thiazides which do the opposite (increase body Ca but prevent renal Ca excretion)

I never go for Loops on these questions and go for the thiazides but it always seemed kind of weird to me that you would increase total body Ca (is that accurate?)

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[4424]

hey quick question for you guys-

lets say a pt has recurrent calcium stones with hypercalcemia and youve given IVF/pain control and the question asks for your next treatment (ive seen this in a couple of places for Step 1 and 2)

I know you dont want to give loops (decrease body Ca but increase renal Ca) but what about thiazides which do the opposite (increase body Ca but prevent renal Ca excretion)

I never go for Loops on these questions and go for the thiazides but it always seemed kind of weird to me that you would increase total body Ca (is that accurate?)

but you are also decreasing the calcium in the urine which would decrease stone formation

 

[ucbdancn00]

hey quick question for you guys-

lets say a pt has recurrent calcium stones with hypercalcemia and youve given IVF/pain control and the question asks for your next treatment (ive seen this in a couple of places for Step 1 and 2)

I know you dont want to give loops (decrease body Ca but increase renal Ca) but what about thiazides which do the opposite (increase body Ca but prevent renal Ca excretion)

I never go for Loops on these questions and go for the thiazides but it always seemed kind of weird to me that you would increase total body Ca (is that accurate?)

As previously said...the idea behind HCTHZ is to help decrease the amount of Ca2+ in the urine by increase renal absorption. Of course this requires copious monitoring in patients with already high normal Ca levels.

hope this helps

ucb

 

[Doc Ivy]

This is also why Thiazides are usually the drugs of choice for little old osteoporotic ladies with systolic hypertension, in this case you take advantage of the decreased calciuresis and resulting increased serum calcium