Endocrine Pharmacology: Calcium Homeostasis
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Questions and Answers

What is a side effect of prolonged administration of glucocorticoids in children?

  • Retarded growth (correct)
  • Osteonecrosis of the jaw
  • Breast cancer
  • Hypocalcemia

    • What is the mechanism of action of bisphosphonates?

  • Inhibition of osteoclast apoptosis
  • Enhancement of calcium absorption
  • Stimulation of osteoclast apoptosis (correct)
  • Stimulation of osteoblast activity

    • What is the recommended administration of bisphosphonates?

  • On a full stomach with a full glass of water and remaining standing for 30 minutes
  • On an empty stomach with a full glass of water and remaining standing for 30 minutes (correct)
  • With food and remaining sitting for 30 minutes
  • With a full glass of water and lying down for 30 minutes

    • What is the treatment for hypercalcemia associated with malignancy?

    <p>Diuresis with furosemide and hydrocortisone</p> Signup and view all the answers

    What is the cause of 90% of cases of hypercalcemia?

    <p>Hyperparathyroidism and malignancy</p> Signup and view all the answers

    What is the function of estrogen in the treatment of osteoporosis?

    <p>To decrease bone resorption</p> Signup and view all the answers

    What is the side effect of prolonged use of estrogen in the treatment of osteoporosis?

    <p>Breast cancer and endometrial carcinoma</p> Signup and view all the answers

    What is the treatment for hypocalcemia?

    <p>Calcium gluconate infusion slowly i.v.</p> Signup and view all the answers

    What is the therapeutic use of synthetic parathormone (teriparatide)?

    <p>Treatment of osteoporosis</p> Signup and view all the answers

    What is the effect of calcitonin on serum calcium levels?

    <p>Decreases serum calcium levels</p> Signup and view all the answers

    What is the mechanism of action of vitamin D?

    <p>Increases calcium absorption from the intestine and decreases its excretion by the kidney</p> Signup and view all the answers

    What is the site of activation of vitamin D?

    <p>Kidney and liver</p> Signup and view all the answers

    What is the source of vitamin D2?

    <p>Plant sources</p> Signup and view all the answers

    What is the side effect of using parathormone for more than 2 years?

    <p>Osteosarcoma</p> Signup and view all the answers

    What is the effect of calcitonin on bone resorption?

    <p>Inhibits bone resorption</p> Signup and view all the answers

    What is the therapeutic use of salmon calcitonin?

    <p>Treatment of hypercalcemia and osteoporosis</p> Signup and view all the answers

    Study Notes

    Hormonal Regulators of Ca+2 Metabolism and Bone Mineral Homeostasis

    • Parathormone (PTH) is a single chain polypeptide secreted by the parathyroid glands.

    • Synthetic PTH (teriparatide) is used in treatment of osteoporosis, but has a risk of osteosarcoma with long-term use.

    • PTH increases serum calcium by increasing calcium reabsorption in the kidney, stimulating bone resorption, and stimulating vitamin D activation.

    • Low intermittent doses of PTH produce an increase in bone formation.

    • Calcitonin (CT) is a single chain polypeptide secreted by the C-Cells of the thyroid.

    • Calcitonin decreases serum calcium by decreasing calcium reabsorption in the kidney and inhibiting bone resorption.

    • Salmon CT is used in treatment of hypercalcemia and osteoporosis.

    • Vitamin D is a fat-soluble vitamin found in two forms: Vitamin D2 (plants) and Vitamin D3 (animals and human skin).

    • Vitamin D increases serum calcium by increasing calcium absorption from the intestine and decreasing its excretion by the kidney.

    • Vitamin D is used in treatment of hypocalcemia, osteoporosis, and rickets.

    • Glucocorticoids can cause osteoporosis in adults and retarded growth in children due to increased renal Ca2+ excretion and decreased bone formation.

    • Estrogen decreases bone resorption and is used in treatment of postmenopausal osteoporosis.

    • Selective estrogen receptor modulators (Raloxifene) stimulate estrogen receptors in bones and block them in the breast and uterus.

    Non-Hormonal Regulators of Ca2+ Metabolism and Bone Mineral Homeostasis

    • Bisphosphonates (Alendronate) inhibit bone resorption by stimulating osteoclast apoptosis.

    • Bisphosphonates are used in treatment of hypercalcemia associated with malignancy and bone lesions associated with bone metastasis, and treatment of osteoporosis.

    • Bisphosphonates can cause renal impairment and osteonecrosis of the jaw as side effects.

    • Thiazide and furosemide are used to treat hypercalcemia by increasing urine flow and enhancing Ca2+ excretion.

    • Fluoride is used to treat osteoporosis.

    • Hypercalcemia is caused by hyperparathyroidism or malignancy in 90% of cases.

    • Treatment of hypercalcemia includes diuresis, hydrocortisone, intravenous bisphosphonates, and hemodialysis.

    • Hypocalcemia is caused by hypoparathyroidism, chronic renal failure, and vitamin D deficiency, and is treated with a diet rich in calcium and calcium gluconate.

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    Description

    This quiz covers the regulation of calcium metabolism and bone mineral homeostasis, including hormonal regulators such as parathormone and calcitonin.

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