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34 Cards in this Set
- Front
- Back
Organs involved in calcium regulation?
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Intestine(10-20% absorbed)
Kidney(99% absorbed) Bone |
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Calcium in Bone?
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1 KG, 99% stable, 4-5 grams of exchangable calcium, 20 grams per day turnover
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Symptoms of hypocalcemia?
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Neuromuscular tetany, muscle cramps, convulsions, laryngiospasms, Rickets, osteomalacia
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Causes of Hypocalcemia?
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Diatry calcium of Vit D, malabsorption due to Vit D activation or endorgan resistance, hypoparathyroidism, renal failure
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Symptoms of hypercalcemia?
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Cardiac arrhythias, renal damage(calculi), soft tiddue calcification, CNS abnormalities
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Causes of hypercalcemia?
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hyperparathyroidism, Hypervitiminosis D, Sarcoidosis, neoplasia, hyperthyroidism
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types of Vit D
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Vit D2: from UV
Vit D3: from diet |
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Activation of Vit D
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Vit D to 25-OH-Vit D in liver
25-OH-Vit D to 1,25-diOH-Vit D in kidneys. Inhibeted by Calcium, phosphate, and 1,25-diOH-Vit D, activated by PTH of low phoshate |
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Calcium effects on Vit D
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Inhibits directly and indirectly by decreasing PTH
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Therapeutic use of Vit D
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Prophylaxis and cure of rickets/ osteomalacia, htpoparathyroidism and osteoporosis
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Actions of PTH?
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directly on kidneys to stimulate reabsorption of Calcium, activates Vit D, decreases PO4 reabsorption, increase calcium resorption from bone
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PTH as a diagnostic tool?
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Examine cAMP production by kidneys to detect pseudohypoparathyroidism
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Treatment for hypoparathyroidism?
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Calcium and Vit D
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Treatment for hyerparathyroidism?
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Surgical resection
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Actions of Calcitonin?
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Decrease Calcium absorption from intestines, increase urinary excretion of Calcium, Magnesium, Cloride, phosphate, inhibits ostroclasts
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Therapeutic use of Calcitonin?
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treat paget's disease, osteoporosis, hypercalcemia associated with malignancy, Vit D toxicity
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Gallium nitrate indication?
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Hypercalcemia of malignancy, decreases bone resorption
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Glucocorticoid indication?
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Hypercalcemia associated with sarcoidosis or Vit D toxicosis, noy PTH induced
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Glucocorticoid MOA?
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Antagonize aaction of Vit D
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Thiazide Indication and site of action?
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Renal hypercalciuria, early segment of distal tubule, inhibits renal stone formation
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Bisphosphonates?
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Etidronate, Pamidronate B, Aldendronate
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Pharmacokinetics of Bisphosphonates?
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Low absorption when orally administered, decreased further by food!, short plasma half-life, but half-life after deposition is long
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Bisphosphonates Contraindications?
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Children, pregnancy, breast feeding, GIulcers, decreased renal function.
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Drug interactions of Bisphosphonates?
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Al(OH)3, Antacids, Ca, Mg,Fe salts,NSAIDs -None with Palmidronate (i.v.)
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Indications of Bisphosphonates?
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Paget’s disease, Osteoporosis
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Bisphosphonates MOA?
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absorbs into bone, inhibits osteoclast, decrease activation of Vit D
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Flouride MOA?
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Mitogen for osteoblast bone formation
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Flouride CI?
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arthralgia, pregnancy, breast-feeding, children, dental fluorosis-mottled enamel
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Flouride adverse effects?
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Dermatitis, GI bleeding...
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Estrogen indication?
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Post-menopausal women to prevent osteoporosis
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SERMs?
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Specific Estrogen Receptor Modulators
Reloxifene, increased risk of DVT's |
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Teriparatide?
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1-34 PHT for osteoporosis
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Teriparatide CI?
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Paget's and kids b/c causes osteosarcoma
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Cinacalcet, MOA, indications?
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Calcium mimetic, inhibits PTH release, secondary hyperparathyroidism, parathyroid carcinoma, chronic kidney disease
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