Hyperparathyroidism versus Hyperparathyroidism
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Parathyroid glands’ goal is to increase calcium in the blood
Hyperparathyroidism
⇑ calcium ⇓ phosphorus
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Causes
- Primary: Tumor or hyperplasia of parathyroid
- Secondary: Chronic kidney failure, ⇓ Vitamin D
Depressed DTR’s, muscle weakness, fatigue, hypophosphatemia
- Parathyroidectomy- removal of one or more glands or remove tumor for primary hyperparathyroidectomy
- Administer: Phosphates or Calcitonin (decreases calcium)
- Diet: low calcium and high phosphorus diet
Shortened ST Segment
Hypoparathyroidism
⇓ Calcium ⇑ Phosphorus
- Accidental removal of parathyroid during thyroidectomy.
- Genetic
- Exposure to radiation
- Magnesium Depletion
IMPORTANT: bronchospasms and dysphagia an occur. Keep trach kit at bedside.
- Oral calcium
- Phosphorus binding drugs if phosphorus high (calcium acetate, Sevelamer)
- IV calcium or magnesium
- IV calcium gluconate
- Oral Vitamin D (vitamin D necessary for calcium absorption)
- Diet: increase calcium and decrease phosphorus
Prolonged QT interval
Hypocalcemia = prolonged QT and Hypercalcemia = Shortened ST Segment
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Thiazides and Lithium
Increase Calcium levels. These drugs must be avoided in hypercalcemia