Pseudohypoparathyroidism Medication

  • Author: Mini R Abraham, MD; Chief Editor: George T Griffing, MD   more...
 
Updated: Dec 13, 2011
 

Medication Summary

The goals of pharmacotherapy are to correct calcium deficiency, to prevent complications, and to reduce morbidity. Intravenous calcium is the initial treatment for all patients with severe symptomatic hypocalcemia. Administration of oral calcium and 1alpha-hydroxylated vitamin D metabolites, such as calcitriol, remains the mainstay of treatment and should be initiated in every patient with a diagnosis of PHP. Maintaining serum total and ionized calcium levels within the reference range discourages hypercalciuria and suppresses PTH levels to normal.

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Calcium salts

Class Summary

These agents are used for calcium electrolyte supplementation.

Calcium chloride

 

Calcium chloride improves nerve and muscle performance by regulating the action potential excitation threshold affected by calcium deficiency.

Calcium gluconate (Cal-G, Cal-GLU)

 

Calcium gluconate moderates nerve and muscle performance and facilitates normal cardiac function. It can be initially administered intravenously, and calcium levels can be maintained with a high-calcium diet. Some patients require oral calcium supplementation.

Calcium carbonate (Oystercal, Caltrate, Os-Cal, Tums)

 

Calcium carbonate is used for supplementation of intravenous therapy in hypocalcemia. Calcium moderates nerve and muscle performance by regulating the action potential excitation threshold.

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Vitamins, Fat-Soluble

Class Summary

Supplementation increases calcium levels in the serum by improving calcium absorption and retention.

Calcitriol (Calcijex, Rocaltrol, Vectical)

 

Calcitriol increases calcium levels by promoting calcium absorption in the intestines and retention in kidneys.

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Contributor Information and Disclosures
Author

Mini R Abraham, MD  Consulting Staff, Overland Park Medical Specialists

Mini R Abraham, MD is a member of the following medical societies: American Association of Clinical Endocrinologists and Endocrine Society

Disclosure: Nothing to disclose.

Coauthor(s)

Romesh Khardori, MD, PhD, FACP  Professor of Endocrinology, Director of Training Program, Division of Endocrinology, Diabetes and Metabolism, Strelitz Diabetes and Endocrine Disorders Institute, Department of Internal Medicine, Eastern Virginia Medical School

Romesh Khardori, MD, PhD, FACP is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Diabetes Association, and Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Stanley Wallach, MD Executive Director, American College of Nutrition; Clinical Professor, Department of Medicine, New York University School of Medicine

Stanley Wallach, MD is a member of the following medical societies: American College of Nutrition, American Society for Bone and Mineral Research, American Society for Clinical Investigation, American Society for Clinical Nutrition, American Society for Nutritional Sciences, Association of American Physicians, and Endocrine Society

Disclosure: Nothing to disclose.

Kent Wehmeier, MD Professor, Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, St Louis University School of Medicine

Kent Wehmeier, MD is a member of the following medical societies: American Society of Hypertension, Endocrine Society, and International Society for Clinical Densitometry

Disclosure: Nothing to disclose.

References
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  11. Mantovani G, Bondioni S, Linglart A, Maghnie M, Cisternino M, Corbetta S. Genetic analysis and evaluation of resistance to thyrotropin and growth hormone-releasing hormone in pseudohypoparathyroidism type ib. J Clin Endocrinol Metab. Sep 2007;92(9):3738-42. [Medline].

  12. Mahmud FH, Linglart A, Bastepe M, et al. Molecular diagnosis of pseudohypoparathyroidism type Ib in a family with presumed paroxysmal dyskinesia. Pediatrics. Feb 2005;115(2):e242-4. [Medline].

  13. Freson K, Izzi B, Labarque V, et al. GNAS defects identified by stimulatory G protein alpha-subunit signalling studies in platelets. J Clin Endocrinol Metab. Dec 2008;93(12):4851-9. [Medline].

  14. Weinhaeusel A, Thiele S, Hofner M, et al. PCR-based analysis of differentially methylated regions of GNAS enables convenient diagnostic testing of pseudohypoparathyroidism type Ib. Clin Chem. Sep 2008;54(9):1537-45. [Medline].

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Patient with pseudohypoparathyroidism showing shortened fourth metacarpals.
 
 
 
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