NURSING ANM AND GNM

Detailed explanation-1: -Too much calcium in the blood In rare cases, the increased cycle of bone renewal in Paget’s disease of bone can result in calcium building up in the blood. This is known as hypercalcaemia. It usually only occurs in people who have been confined to bed after an operation or a fracture.

Detailed explanation-2: -A recent study suggested that primary hyperparathyroidism often is present in patients with thiazide-associated hypercalcemia and that the hypercalcemia usually is mild and nonprogressive in these cases (NEJM JW Gen Med Apr 15 2016 and J Clin Endocrinol Metab 2016; 101:1166).

Detailed explanation-3: -By increasing calcium reabsorption from the luminal membrane into the interstitium in exchange for sodium, thiazides reduce urine calcium levels and increase blood calcium. However, if indicated, this effect of thiazide diuretics makes thiazides useful for nephrolithiasis and osteoporosis treatment.

Detailed explanation-4: -Thiazides are used for idiopathic hypercalciuria but are avoided in PHPT to prevent exacerbating hypercalcemia.