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DI lecture HyperPhos

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alchemist04's version from 2016-10-04 05:57

Section

Question Answer
What is the range for HyperPhos?> 4.5 mg/dL
Which kind of pt do you normally find Hyperphos?Renal impaired pt.
What is the most common cause of Hyper phos?Renal impairment (dysfunction. Hence, becareful w/ pt ondialysis)
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Question Answer
How do FGF23 regulates HyperPhos?Increase in Phos causes increase in FGF23 stimulation. Increase in FGF23 causes inhibition of Vit D activation which result in decrease in Ca stimulation, decrease in absorption of Calcium, increase in phosphate excretion
How does PTH regulate Phos?decrease in Calcium causes increase release of PTH which causes bone resoption, increase in renal reabsorption of Ca and decrease in phosphate via kidney (+ increase in renal excretion of Phos)
At what value does Calcification occurs?when Ca value * Phos value < 55 mg/dL
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Question Answer
T or F, you only have Phosphate binders for the treatment of HyperPhos?T
What are the types of Phosphate binders for HyperPhos? (1)(1) Calcium-containing products (Calcium carbonate and acetate)
What are the types of Phosphate binders for HyperPhos? (2)(2) Al/Mg containing products (Al products and Mg products)
What are the types of Phosphate binders for HyperPhos? (3)(3) Sevelamer (S. HCl = Renagel and S. Carbonate = Renvela)
What are the types of Phosphate binders for HyperPhos? (4)(4) Lanthanum ( L. Carbonate = Forsrenol)
What are the types of Phosphate binders for HyperPhos? (5)(5) Sucroferric oxyhydroxide (Velphoro)
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Question Answer
What is the usual dose for Calcium carbonate (TUMS)?1-1.5 g TID, has 40% elemental calc.
Why is Calcium Acetate is less preferred to Calcium Carbonate?Cal acetetate is more potent and costlier
What is the max amount of elemental Cal product to be given per day?2g elemental calcium/day
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What are the disadvantages of giving Al containing products?(1) Very potent (2) Al accumulation and toxicity (3) can only be used for short term (4wks) if the Phos level is > 7 mg/dL
What are the disadvantages of using Mg products?(1) high dose is required (2) could cause severe diarrhea (3) could cause hypermagnesemia (makes sense since pt is taking high dose of Mg product)
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Question Answer
What is the dose for Sevelamer?800 - 1600 mg PO TID
Renagel or Renvela, which one contains HCL and which one contains Carbonate?Renegal = HCl while Renvela = Carbonate (L for HCl and a for Carbonate)
Why is Renvela preferable to Renagel?Renagel could cause metabolic acidosis because of its HCL content. Caution in pt w/ CDK
T or F, Sevelamer is advantageous bc it has no significant effect on serum Calcium?T
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Question Answer
Which Phosphate Binders are cheawables?(1) Lanthanum Carbonate (Fosrenol) and (2) Sucroferric Oxyhydroxide (Velphoro)
Both Fosrenol and Velphoro has the same dosage and maximum dosage per day, what are they?Dosage = 500 mg PO TID, Max = 3 g PO QD
Which of the Phosphate binders could cause dark stool?Sucroferric oxyhydroxide (Velphoro)
Which of the Phosphate binders could cause bowel obstruction?Lanthanum carbonate (Fosrenol)
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