Which medications in the drug class Antidote, Hypercalcemia are used in the treatment of Hypercalcemia in Emergency Medicine?

Updated: Apr 11, 2018
  • Author: Thomas E Green, DO, MPH, MMM, CPE, FACEP, FACOEP; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Antidote, Hypercalcemia

Inhibit RNA synthesis in osteoclasts and effective in treatment of hypercalcemia.

Calcitonin (Miacalcin, Cibacalcin, Calcimar)

A naturally occurring hormone that inhibits bone reabsorption and increases excretion of calcium. Most rapid onset of action of anticalcemic agents. Effects may be observed within a few hours with peak response at 12-24 h; because of short duration of action, other more potent but slower-acting agents should be started in patients with severe hypercalcemia. Salmon calcitonin is used most often and is more potent than human calcitonin. Action of this agent is short-lived. If elevation of calcium is severe, coadminister 1-2 doses with fluids and Lasix to provide a rapid, although limited, reduction of the calcium level.

Gallium nitrate (Ganite)

Works by inhibiting bone reabsorption and altering structure of bone crystals.

Exerts hypocalcemic effect, possibly by reducing bone resorption; performs well against other anticalcium agents but has slow onset of action.

Plicamycin

No longer manufactured and distributed in the United States. Inhibits cellular ribonucleic acid (RNA) and enzymatic RNA synthesis. Possibly blocks hypercalcemic action of pharmacologic doses of vitamin D and may act on osteoclasts or block action of parathyroid hormone. Effect in lowering calcium is not related to tumoricidal activity.


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