Calcium and Vitamin D Flashcards Preview

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Flashcards in Calcium and Vitamin D Deck (8)
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1
Q

Indications

A
  1. Used in osteoporosis to ensure positive calcium balance when dietary intake and/or sunlight exposure are insufficient
  2. Used in CKD to treat and prevent secondary hyperparathyroidism and renal osteodystrophy
  3. Used in severe hyperkalaemia to prevent life-threatening arrhythmias
  4. Used in hypocalcaemia that is symptomatic
  5. Used in prevention and treatment of vit D deficiency
2
Q

Mechanism of action

A

Calcium is essential for normal function.

Ca homeostasis is controlled by parathyroid hormone and vit D, which increase Ca levels and bone mineralisation, and calcitonin which reduces the serum Ca levels.

In osteoporosis there is a loss of bone mass which increases the risk of fracture.
Restoring a positive calcium balance can slow the bone loss.

In severe chronic kidney disease impaired phosphate excretion and reduced activation of vitamin D cause hyperphosphataemia and hypocalceamia. This stimulates secondary hyperparathyroidism, which leads to renal osteodystrophy.

In hyperkalaemia calcium raises the myocardial threshold potential reducing excitability.

3
Q

Adverse effects

A

Dyspepsia

4
Q

Interactions

A

Oral calcium reduces the absorption of many drugs eg iron, bisphosphonates, tetracyclines, levothyroxine

5
Q

Prescribing

A

Osteoporosis - aim to supplement dietary intake

Severe hyperkaleamia - 10ml of calcium gluconate 10% by slow IV injection. Repeat of ECG changes persist.

Seek guidance for use in severe/symptomatic hypocalcaemia and severe CKD

6
Q

Administration

A

Oral preparations are usually chewed

7
Q

Communication

A

Depends on indication

8
Q

Monitoring

A

Patients with severe hyperkalaemia require continuous cardiac monitoring. You should repeat a 12-lead ECG after administration of calcium to confirm treatment success.

Any patient receiving calcium supplementation should have their levels monitored.