another controversy with uw and other books - macrophagearetheshit

[ArchivalUser]

what is best management of hypercalcemia sec to bone mets? uw says bisphosponates but everywhere else say start with NS, and then go to bisphophonates. what should b the right ans?

can somebody plz plz plz clarify? thank you so much.

[ArchivalUser]

Hi macrophage, in my opinion start always with NS (if no renal failure) due to their dilutional effect+ expansion of extracell volume...> increase clearance of calcium ) + loop diuretics+ Bisphosphonates.
Mithramycin is a good option too in case of Hyperclacemia due to mets.

[ArchivalUser]

thanks dream88, but according to uw, bisphosphonates will provide protection against future osteoprosis and will help with hypercalcemia as well. they quoted one of the article from ASCO, but one guideline i found also said use NS. so dont know which one to pick.