Parathyroid drugs
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antihypercalcemic drugs: treat excessive parathyroid hormone or hypercalcemia.
biophosphonates: alendronate (Fosamax)
calcitonin: calcitonin salmon (miacalcin, fortical)
Antihypocalcemic drugs: treat deficient levels of parathyroid hormone
teriparatide (forteo)
calcitriol(rocaltrol)
mechanism of action:
A vitamin drug regulates the absorption of calcium and phosphate and reabsorption of phosphate from renal tubules, increasing serum calcium level
teriparatide stimulates new bone formation leading to increase in skeletal mass, it increase serum calcium and decrease serum phosphorus
indications
management of hypocalcemia in patients with chronic renal dialysis
manage hypocalcemia associated with hypoparathyroidism and with sustained systemic glucocorticoid therapy
route: per os
contraindications
hypercalcemia or vitamin D toxicity
pregnancy and lactation: potential adverse effect on fetus , calcitriol is associated with hypercalcemia in the baby when used by nursing mothers
allergy to any component of the drug
teriparatide is associated with osteosarcoma
Side effect
Central nervous system:
gastrointestinal:
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headache
somnolence and irritability
body weakness
nausea and vomiting
dry mouth and constipation
metallic taste
mechanism of action
- calcitonin inhibits bone resorption and lowers serum calcium, > increases excretion of filtered phosphate, calcium and sodium by kidneys
biophosphonates slow normal and abrnomal bone resorption without inhibiting bone formation and mineralisation
indications
bisphosphonate
calcitonin
treat and prevent osteoporosis in post menopausal women
also treat glucocorticoid-induced osteoporosis and treat Paget's disease
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treat Paget's disease
treat menopausal osteoporosis
emergency treatment of hypercalcemia
route: per os
contraindications:
renal dysfunction: can alter drug excretion
upper gastrointestinal diseas: can be aggravated by bisphosphonates, esophegeal erosion can occur
pregnancy and lactation: potential adverse effect on the fetus
allergy to salmon of fish product
hypocalcemi, worsen by calcium-lowering effect of bisphophonate
pernicious anemia, can be worsen by calcitonin
allergy to any componrnt of the drug
side effects
calcitonins
skin rash
nausea and vomiting
flushing of the hands and face
urinary frequency
local inflammation at the site of injection
bisphophonates
nausea
diarrhea
headache