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A pamidronate is any salt or ester of pamidronic acid, or the sodium salt of pamidronic acid, used to treat osteoporosis.
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What would a cat take for milk fever?
* Intravenous fluids * Bisphosphonates (drugs that stop bone resorption such as pamidronate or etidronate) * Calcitonin * Glucocorticoids (steroids, for hypervitaminosis D that is not medication related) * Hemodialysis (for hypercalcemia that is unresponsive to treatment and is life-threatening)
Where can you get pamidronate injection in Mumbai?
Try the biggest drug store in mumbai - Royal Chemist Address : 89-A, Queen's Chambers M. Karve Road, Marine Lines, Mumbai - 400020 India. Telphone : +91 22 2200 4041/42/43 Fax : +91 22 2200 4044
Is there a cure for osteogenesis imperfecta?
There is no cure for OI but there is a drug available from some hospitals called Pamidronate which helps to increasethe bone density of the patient.It's more effective in children who are still growing but can help older people aswell
Hypercalcemia?
DefinitionHypercalcemia is too much calcium in the blood.Causes, incidence, and risk factorsCalcium is important to many body functions, including:Bone formationHormone releaseMuscle contractionNerve and brain functionParathyroid hormone (PTH) and vitamin D help manage calcium balance in the body. PTH is made by the parathyroid glands -- four small glands located in the neck behind the thyroid gland. Vitamin D is obtained when the skin is exposed to sunlight, and from dietary sources such as:Egg yolksFishFortified cerealsFortified dairy productsPrimary hyperparathyroidism is the most common cause of hypercalcemia. It is due to excess PTH release by the parathyroid glands. This excess occurs due to an enlargement of one or more of the parathyroid glands, or a growth (usually not cancer) on one of the glands.Other medical conditions can also cause hypercalcemia:Adrenal glandfailureBeing bedbound (or not being able to move) for a long period of timeCalcium excess in the diet (called milk-alkali syndrome, usually due to at least 2,000 milligrams of calcium per day)An inherited condition that affects the body's ability to regulate calcium (familial hypocalciuric hypercalcemia)HyperthyroidismKidney failureMedications such as lithium and thiazide diuretics (water pills)Some cancerous tumors (for example, lung cancers, breast cancer)Vitamin D excess (hypervitaminosis D) from diet or inflammatory diseasesHypercalcemia affects less than 1 percent of the population. The widespread ability to measure blood calcium since the 1960s has improved detection of the condition, and today most patients with hypercalcemia have no symptoms.Women over age 50 are most likely to have hypercalcemia, usually due to primary hyperparathyroidism.SymptomsAbdominal:ConstipationNauseaPainPoor appetiteVomitingKidney:Flank painFrequent thirstFrequent urinationMuscular:Muscle twitchesWeaknessPsychological:ApathyDementiaDepressionIrritabilityMemory lossSkeletal:Bone painBowing of the shouldersFractures due to disease (pathological fractures)Loss of heightSpinal column curvatureSigns and testsSerum calciumSerum PTHSerum PTHrP (PTH-related protein)Serum vitamin D levelUrine calciumTreatmentTreatment is directed at the cause of hypercalcemia whenever possible. In more severe cases of primary hyperparathyroidism, surgery may be needed to remove the abnormal parathyroid gland(s) and cure the hypercalcemia.However, if your hypercalcemia is mild and caused by primary hyperparathyroidism, your health care provider will most likely recommend that you not have surgery, but will monitor your condition closely over time.Severe hypercalcemia that causes symptoms and requires a hospital stay is treated with the following:CalcitoninDialysisDiuretic medication, such as furosemideDrugs that stop bone breakdown and absorption by the body, such as pamidronate or etidronate (bisphosphonates)Fluids through a vein (intravenous fluids)Glucocorticoids (steroids)Expectations (prognosis)How well you do depends on the cause of hypercalcemia. Patients with mild hyperparathyroidism or hypercalcemia with a treatable cause do well and do not have complications.Patients with hypercalcemia due to conditions such as cancer or granulomatous disease may not do well, but this is usually due to the disease itself, rather than the hypercalcemia.ComplicationsGastrointestinalPancreatitisPeptic ulcerdiseaseKidneyCalcium deposits in the kidney (nephrocalcinosis)DehydrationHigh blood pressureKidney failureKidney stonesPsychologicalDepressionDifficulty concentrating or thinkingSkeletalBone cystsFracturesOsteoporosisThe complications of long-term hypercalcemia are uncommon today.Calling your health care providerContact your physician or health care provider if you have:Family history of hypercalcemiaFamily history of hyperparathyroidismSymptoms of hypercalcemiaPreventionMost causes of hypercalcemia cannot be prevented. Women over age 50 should see their health care provider regularly and have their blood calcium level checked if they have symptoms of hypercalcemia.You can avoid hypercalcemia from calcium and vitamin D supplements by contacting your health care provider for advice about the dose if you are taking supplements without a prescription.ReferencesBringhurst R, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 27.Wysolmerski JJ, Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 266.
Multiple myeloma?
DefinitionMultiple myeloma is cancer of the plasma cells in bone marrow.Alternative NamesPlasma cell dyscrasia; Plasma cell myeloma; Malignant plasmacytoma; Plasmacytoma of bone; Myeloma - multipleCauses, incidence, and risk factorsPlasma cells help the body's immune system fight disease by producing proteins called antibodies. In multiple myeloma, plasma cells grow out of control in the bone marrow and form tumors in the areas of solid bone.The growth of these bone tumors makes it harder for the bone marrow to make red blood cells, white blood cells, and platelets. This causes anemia, which makes a person more likely to get infections and have abnormal bleeding.As the cancer cells grow in the bone marrow, they can cause pain and destruction of the bones. If the bones in the spine are affected, it can put pressure on the nerves, resulting in numbness or paralysis.Multiple myeloma mainly affects older adults. A history of radiation therapy raises your risk for this type of cancer.SymptomsBleeding problemsBone or back pain, most often in the ribs or backFevers without any other causeIncreased susceptibility to infectionSymptoms of anemia (such as tiredness, shortness of breath, and fatigue)Unexplained fracturesWeakness of the arms or legsSigns and testsBlood tests can help diagnose this disease. They may include:Blood chemistrymay show increased levels of calcium, total protein, and abnormal kidney functionComplete blood count (CBC) reveals low numbers of red and white blood cells and plateletsSerum beta 2 microglobulin levelSerum immunofixation electrophoresisUrine immunofixation electrophoresisSerum protein electrophoresis (SPEP)Urine protein electrophoresis (UPEP) or Bence-Jones protein analysisQuantitative immunoglobulins (nephelometry)Serum free light chain measurementsBone x-rays may show fractures or hollowed out areas of bone. If your doctor suspects this type of cancer, a bone marrow biopsy will be performed.Bone density testing may show bone loss.TreatmentThe goal of treatment is to relieve symptoms, avoid complications, and prolong life.People who have mild disease or where the diagnosis is not certain are usually carefully watched without treatment. Some people have a slow-developing form of multiple myeloma that takes years to cause symptoms.Medications for the treatment of multiple myeloma include:Dexamethasone, melphalan, thalidomide, lenalidomide (Revlimid), and bortezomib (Velcade) can be used alone or together.Drugs called bisphosphonates (pamidronate) are used to reduce bone pain and prevent fractures.Radiation therapy may be performed to relieve bone pain or treat a bone tumor.Two types of bone marrow transplantation may be tried:Autologous bone marrow or stem cell transplantation makes use of one's own stem cells. In younger patients, it has been shown to increase survival.Allogeneic transplant makes use of someone else's stem cells. This treatment carries serious risks.People with multiple myeloma should drink plenty of fluids to prevent dehydrationand help maintain proper kidney function. They should also be cautious when having x-ray tests that use contrast dye.Support GroupsThe stress of illness may be eased by joining a support group whose members share common experiences and problems. See: Cancer - support groupExpectations (prognosis)Survival of people with multiple myeloma depends on the patient's age and the stage of disease. Some cases are very aggressive, while others take years to get worse.Chemotherapy and transplants rarely lead to a permanent cure.ComplicationsKidney failureis a frequent complication. Other complications may include:Bone fracturesHigh levels of calcium in the blood, which can be very dangerousIncreased chances for infection (especially pneumonia)Paralysis from tumor or spinal cord compressionCalling your health care providerCall your doctor if you have multiple myeloma and infection develops, or numbness, loss of movement, or loss of sensation develops.ReferencesNational Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Multiple Myeloma. National Comprehensive Cancer Network; 2010. Version 1.2010.Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 110.
Parathyroid cancer?
DefinitionParathyroid cancer is a cancerous (malignant) growth in a parathyroid gland.Alternative NamesParathyroid carcinomaCauses, incidence, and risk factorsThe parathyroid glands are responsible for managing the calcium levels in the body. There are four parathyroid glands, two on top of each lobe of the thyroid gland. They are located at the base of the neck.Parathyroid cancer is an extremely rare type of cancer. Men and women are equally affected. It usually occurs in people older than 30.The cause of parathyroid cancer is unknown. People with multiple endocrine neoplasia type I have an increased risk for this disease. People who had head or neck radiation may also be at increased risk. Such radiation exposure, however, is more likely to cause thyroid cancer.SymptomsSymptoms of parathyroid cancer are primarily caused by high levels of calcium in the blood (hypercalcemia), and may affect various parts of the body. They include:Bone painConstipationFatigueFracturesFrequent thirstFrequent urinationKidney stonesMuscle weaknessNauseaPoor appetiteVomitingIt is important to note that only about 1 out of 200 people with primary hyperparathyroidism have parathyroid cancer.Signs and testsParathyroid cancer is extremely hard to diagnose.Your doctor will perform a physical exam and ask about your medical history.In about half of all cases, feeling the neck with the hands (palpation) can reveal a cancerous parathyroid tumor.Cancerous parathyroid tumors tend to produce very high amounts of parathyroid hormone (PTH). Tests may include:Blood calcium(levels higher than 14 mg/dL are suspicious)Blood PTH(levels that are more than twice than normal may indicate cancer)Before surgery, you will undergo a special radioactive scan of the parathyroid glands. The scan is called the sestamibi scan. You may also have a neck ultrasound. These tests are done to confirm which parathyroid gland is abnormal.TreatmentThe following treatments may be used to correct hypercalcemia due to parathyroid cancer:A drug that lowers levels of calcium in the blood (gallium nitrate)A natural hormone produced by the body that helps control calcium levels (calcitonin)Drugs that stop the breakdown and reabsorption of bones into the body, such as pamidronate or etidronate (bisphosphonates)Fluids through a vein (IV fluids)Surgery is the recommended treatment for parathyroid cancer. Very often, it is impossible to know whether a parathyroid tumor is cancerous or not. Your doctor may recommend surgery even without a confirmed diagnosis. Minimally invasive surgery, using smaller cuts, is becoming more common for parathyroid disease.If tests before the surgery can find the suspicious gland, surgery may be done on one side of the neck (unilateral). If it is not possible to find the problem gland before surgery, the surgeon will look at both sides of your neck.Chemotherapy and radiation do not work very well in preventing the cancer from coming back, although radiation can sometimes help reduce the spread of cancer to the bones. Repeated surgeries for cancer that has returned may increase survival rate and reduce the severe effects of hypercalcemia.Expectations (prognosis)Parathyroid cancer is a rare cancer. The tumor is slow growing. Surgery may help extend life even when the cancer spreads.ComplicationsThe cancer may spread (metastasize) to other places in the body, most commonly the lungs and bones.The most serious complication of parathyroid cancer is hypercalcemia. Most deaths from parathyroid cancer occur as a result of severe, difficult to control hypercalcemia, and not the cancer itself.The cancer commonly comes back (recurs). Additional surgeries may be needed. Complications from surgery can include:Hoarseness or voice changes as a result of damage to the nerve that controls the vocal cordsInfection at the site of surgeryLow levels of calcium in the blood (hypocalcemia), a potentially life-threatening conditionScarringCalling your health care providerCall your health care provider if you feel a lump in your neck or experience symptoms of hypercalcemia. ReferencesBringhurst R, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 27.Wysolmerski JJ, Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 266.
Paget's disease of the bone?
DefinitionPaget's disease is a disorder that involves abnormal bone destruction and regrowth, which results in deformity.Alternative NamesOsteitis deformansCauses, incidence, and risk factorsThe cause of Paget's disease is unknown, although it might have to do with genes or a viral infection early in life.The disease occurs worldwide, but is more common in Europe, Australia, and New Zealand.In people with Paget's disease, there is an abnormal breakdown of bone tissue, followed by abnormal bone formation. The new bone is bigger, but weakened and filled with new blood vessels.The disease may only be in one or two areas of the skeleton, or throughout the body. It often involves bones of the:ArmCollarLegPelvisSpineSymptomsBone pain (may be severe and persistent)Bowing of the legs and other visible deformitiesEnlarged headFractureHeadacheHearing lossJoint pain or stiffnessNeck painReduced heightSkull deformitiesWarmth of skin over the affected boneNote: Most patients have no symptoms.Signs and testsTests that may indicate Paget's disease include:Bone scanBone x-rayElevated markers of bone breakdown (for instance, N-telopeptide)Elevated serum alkaline phosphataseThis disease may also affect the results of the following tests:ALP (alkaline phosphatase) isoenzymeSerum calciumTreatmentNot all patients need treatment. For example, patients who have abnormal blood tests only may not need treatment.People with Paget's disease who are commonly treated include:Patients with deformitiesPatients with no symptoms when certain bones (such as weight-bearing bones) are involved, especially if the bony changes are progressing quickly, to reduce the risk of fracturesPatients with symptomsDrug therapy helps prevent further bone breakdown. Currently, there are several classes of medications used to treat Paget's disease. These include:Bisphosphonates -- These drugs are the first-line treatment, and they help increase bone density. Types of bisphosphonates include: Alendronate (Fosamax)Etidronate (Didronel)Pamidronate (Aredia)Risedronate (Actonel)Tiludronate (Skelid)Zoledronic acid (Zometa)Calcitonin -- This hormone is involved in bone metabolism. Types include: Intranasal (Miacalcin)Subcutaneous (Calcimar)Plicamycin (Mithracin)Analgesics or nonsteroidal anti-inflammatory medications (NSAIDs) may also be given for pain.Localized Paget's disease needs no treatment, if there are no symptoms and no evidence of active disease. Orthopedic surgery may be needed to correct a deformity in severe cases.Support GroupsFor additional support and resources, see the Paget Foundation.Expectations (prognosis)Disease activity and symptoms can generally be controlled with current medications. A small percentage of patients may develop a cancer of the bone called osteosarcoma. Some patients will need joint replacement surgery.ComplicationsBone fracturesDeafnessDeformitiesHeart failureParaplegiaSpinal stenosisCalling your health care providerCall for an appointment with your health care provider if you develop symptoms of Paget's disease.ReferencesGoldman L, Ausiello D.Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.
What are the treatments for hypercalcemia?
For those who do NOT know what Hypercalcemia is, let's start with the basics:Hypercalcemia is a condition that is caused by the elevation of calcium (Ca) in the blood; this elevation is due to high concentrations of calcium in the blood's serum. Calcium concentrations in amounts of 12.0 mg/dL or higher can be life threatening, the elevation of calcium in these amounts require urgent treatment. (Normal blood calcium levels are 9.5-10.5 mg/dL.)Initially, there may be little or no symptoms (asymptomatic) of elevated blood calcium levels. In the beginning, symptoms are often nonspecific and worsen as blood calcium levels rise; symptoms may consist of fatigue/lethargy; irregular heart-rate; visual disturbances; increased urination; Natriuresis (loss of sodium through urination); thirst; nausea/vomiting; anorexia; pancreatitis; stomach cramps/pain; constipation; confusion; erratic/usual behavior; depression; hallucinations; delirium; even renal failure. However, more serious symptoms are seizures/convulsions, coma, and heart failure, which can result in death. Women over the age of 50 are most often affected, but anyone, at any age can be affected. (Hypercalcemia is NOT limited to the human population; cats and dogs can also be affected with this condition. The symptoms of hypocalcemia in animals are even less noticeable in animals; they don't complain or show pain; in fact, in nature they tend to hide their pain, a form of protection, thereby protecting them from other animal attacks. In animals, hypercalcemia symptoms may NOT be treated or cared for, over an extended period of time; thereby, death is more apt to be the resulting outcome of many untreated hypercalcemia cases.)Some causes for Hypercalcemia:Thiazide diuretics can cause a rise in blood calcium levels; other causes are kidney stones; a build-up of calcium in the kidney (Nephrocalcinosis); abnormal function of the parathyroid gland (Paget's disease), which raises the level of the parathyroid hormone causing hyperparathyroidism and primary hyperparathyroidism; gout; being immobilized for extended periods of time; familial hypocalciuric hypercalcemia (a genetic disorder); vitamin D intoxication (toxicity caused by vitamin D2 - ergocalciferol and vitamin D3 - cholecalciferol); high blood-pressure; not drinking enough fluids (dehydration); Granulomatous diseases; parathyroid tumors; HIV/Aids; Addison's disease, and more. However, most often Hypercalcemia is associated with forms of malignancies (types of cancers/ tumors are kidney; hematological; leukemia; myeloma; breast; pulmonary; prostate; bladder; colon; stomach; spinal; neck; liver; spleen…). Hypercalcemia that is caused by a malignancy is hard to treat, without treating the cancer too.Malignancies and primary hyperparathyroidism are responsible for more than 80-90% of hypercalcemia cases. Some cases of hypocalcemia are caused by forms of nonlymphoid neoplasm and varied forms of inoperable carcinomas. Another common cause of hypercalcemia is the over production of the parathyroid hormone which results in hyperparathyroidism. Hypercalcemia resulting from a bone malignancy causes the blood's calcium level to rise; this results as the bone(s) breaks down and dissolves as the calcium is leached from the bone into the blood.Now your question is how is hypercalcemia corrected? I assume by "corrected," you mean emergency treatments and preventative treatments.Treatments for Hypercalcemia in the more acute stages:Hypercalcemia in its more dangerous stages requires hospitalization and symptomatic treatment. Medications are used to lower the body's calcium level; enzyme therapy for Pancreatitis (pancreatic secretory block/Celiac plexus blocks); as well as, managing the side effects caused by some forms of the treatments. Other treatments may include Dialysis; Saline infusion; I.V. Diuretics; Calcitonin; I.V. or oral Etidronate Disodium… (Treating hypercalcemia with diuretics can adversely affect potassium levels, thereby causing serious health effects (excess potassium loss can be life threatening). Some treatments may require the use of a potassium-protecting diuretic, which is used to prevent potassium loss.)The most important treatment for Hypercalcemia is prevention:Prevention should start with an accurate diagnosis, finding its precise underlying cause, and follow-up with an appropriate preventive treatment. Treatment should include diet changes and regulation, diet can be used as a preventive or to remove excess calcium that is already in the system. It can also help prevent and treat excessive amounts of vitamin D, i.e., resulting in vitamin D intoxication which has an effect on hypercalcemia. Over-exposure to sunlight/ultraviolet light can also cause a harmful rise in vitamin D levels; it has the same effect as taking excessive vitamin D supplements. But over-exposure to sunlight/ultra violet light has an additional risk, which may cause melanoma or other forms of skin cancers/malignancies. Hemodialysis can be used to remove excess amounts of calcium and vitamin D from the blood. Also avoiding excessive calcium supplements, calcium based antacids… by those who are susceptible to hypercalcemia attacks.Medication can be beneficial in preventing future attacks; treating chronic hypercalcemia; minor flare-ups; or treating those with a family history of hypercalcemia:Prescriptions drugs can help prevent hypercalcemia attacks in those suffering from on-going chronic high blood calcium levels. Treatments may include the use of diuretic medications -- Furosemide (Delone, Lasix, Lo-Aqua, Furocot); Torsemide (Demadex); Methyclothiazide (Aquatensen, Enduron); Bumetanide (Bumex)... can be useful. Other medications used are Zolendronic acid (Reclast, Zometa, Zomera, Aclasta); Pamidronate (Aredia)… Additional treatments used for hypercalcemia may be associated with malignancies/cancers - Pyrophosphoric acid (Bisphosphonate, Diphosphonate) drugs used to avert the loss of bone mass; and drugs that are used to alleviate symptoms or to increase fluids (hydration) in the body. There is a new treatment for Hypercalcemia; this treatment is called Continuous Arteriovenous Hemofiltration Dialysis (CAVH); this procedure can assist in the support of renal failure and its management. Continuous Arteriovenous Hemofiltration Dialysis is also used removing toxins; waste produces; excess amounts calcium; heavy metals; removing excess medications… from the blood.Hypercalcemia probably means to much calcium. I would say the drug of choice is some sort of acid to leach the calcium out.The above answer is absolutely incorrect, other than the fact that Hypercalcemia does mean too much Calcium in the blood. Hypercalcemia is typically caused by hyperparathyroidism which is often times caused by an enlargement of one or more of the parathyroid glands in the neck, situated behind the thyroid gland.The ONLY way to cure hyperparathyroidism and thus, bring calcium levels back to normal, is to have a parathyroidectomy.
