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Medical Treatment of Hyperparathyroidism
- Hyperthyroidism will typically only need to be treated in the Emergency Department when they present with Hypercalcemia.
- Outpatient management of hyperthyroidism consists of serial PTH measurements, Calcium, and Creatinine.
- Hypercalcemia should be treated with normal saline hydration.
- Once the patient is determined to be euvolemic you can enhance diuresis and excretion of calcium by giving the patient furosemide.
- Remember hydrochlorathiazide can actually increase serum calcium by preventing its excretion.
- This patients should receive 4-10 liters of normal saline in the first day.
- You can also give bisphosphonates and calcitonin.
- For high calcium levels with mental status changes consider hemodialysis.