Acute management of cancer-related hypercalcemia

Marie A. Chisholm, Anthony L. Mulloy, A. Thomas Taylor

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

OBJECTIVE: To review the pathogenesis and pharmacologic treatment of acute hypercalcemia associated with malignancy. DATA SOURCES: A MEDLINE search (1966 to 1995) of the English-language literature pertaining to acute hypercalcemia was performed. Additional literature was obtained from reference lists of articles identified through the search. STUDY SELECTION AND DATA EXTRACTION: All articles discussing the etiology and medical management of cancer-related acute hypercalcemia were considered in the review. Clinical trials reporting efficacy and safety of antihypercalcemic agents were also included. Information selected in the review was based on the discretion of the authors. DATA SYNTHESIS: Hypercalcemia is a life- threatening disorder associated with malignancy. It occurs in approximately 10-20% of patients with cancer. A variety of medications have been used in the management of hypercalcemia including bisphosphonates, calcitonin, furosemide, gallium nitrate, glucocorticoids, NaCl 0.9%, and plicamycin. Each of these agents has been reviewed with consideration of pharmacologic mechanism of action, evaluation of clinical trials, recommended dosages, efficacy, safety, cost, and role in treating cancer-related acute hypercalcemia. CONCLUSIONS: Immediate management of cancer-related acute hypercalcemia to prevent death and provide symptomatic relief is warranted. Severity determined by symptoms, calcium concentrations, and the overall status of the patient are important considerations in selecting appropriate therapy. Although the specific role of individual agents may vary, hydration remains the cornerstone of therapy. NaCl 0.9%, calcitonin, and pamidronate disodium have established roles as dominant first-line agents for the management of acute hypercalcemia associated with malignancy.

Original languageEnglish (US)
Pages (from-to)507-513
Number of pages7
JournalAnnals of Pharmacotherapy
Volume30
Issue number5
DOIs
StatePublished - Jan 1 1996

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Hypercalcemia
Neoplasms
pamidronate
Calcitonin
gallium nitrate
Plicamycin
Clinical Trials
Pharmacologic Actions
Safety
Furosemide
Diphosphonates
MEDLINE
Glucocorticoids
Language
Therapeutics
Calcium
Costs and Cost Analysis

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Acute management of cancer-related hypercalcemia. / Chisholm, Marie A.; Mulloy, Anthony L.; Thomas Taylor, A.

In: Annals of Pharmacotherapy, Vol. 30, No. 5, 01.01.1996, p. 507-513.

Research output: Contribution to journalReview article

Chisholm, Marie A. ; Mulloy, Anthony L. ; Thomas Taylor, A. / Acute management of cancer-related hypercalcemia. In: Annals of Pharmacotherapy. 1996 ; Vol. 30, No. 5. pp. 507-513.
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abstract = "OBJECTIVE: To review the pathogenesis and pharmacologic treatment of acute hypercalcemia associated with malignancy. DATA SOURCES: A MEDLINE search (1966 to 1995) of the English-language literature pertaining to acute hypercalcemia was performed. Additional literature was obtained from reference lists of articles identified through the search. STUDY SELECTION AND DATA EXTRACTION: All articles discussing the etiology and medical management of cancer-related acute hypercalcemia were considered in the review. Clinical trials reporting efficacy and safety of antihypercalcemic agents were also included. Information selected in the review was based on the discretion of the authors. DATA SYNTHESIS: Hypercalcemia is a life- threatening disorder associated with malignancy. It occurs in approximately 10-20{\%} of patients with cancer. A variety of medications have been used in the management of hypercalcemia including bisphosphonates, calcitonin, furosemide, gallium nitrate, glucocorticoids, NaCl 0.9{\%}, and plicamycin. Each of these agents has been reviewed with consideration of pharmacologic mechanism of action, evaluation of clinical trials, recommended dosages, efficacy, safety, cost, and role in treating cancer-related acute hypercalcemia. CONCLUSIONS: Immediate management of cancer-related acute hypercalcemia to prevent death and provide symptomatic relief is warranted. Severity determined by symptoms, calcium concentrations, and the overall status of the patient are important considerations in selecting appropriate therapy. Although the specific role of individual agents may vary, hydration remains the cornerstone of therapy. NaCl 0.9{\%}, calcitonin, and pamidronate disodium have established roles as dominant first-line agents for the management of acute hypercalcemia associated with malignancy.",
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