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. Patients with intracranial calcifications may experience seizures related to chronic neuropathic changes, and they may need antiepileptic medications. [4, 5]
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.
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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Patient with pseudohypoparathyroidism showing shortened fourth metacarpals.
