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Last Update: 01/24/2025 08:27 AM

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A 62-year-old man with advanced prostate cancer is admit ted to the emergency department with mental obtundation. An electrolyte panel shows a serum calcium of 16.5 (normal 8.5-10.5 mg/dL). Which of the following therapies would be most useful in the management of severe hypercalccmia?
QType (0=kprim,1=mc,2=sc)
Commit #268356
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(A) Acetazolamide plus saline infusion
(B) Furosemide plus saline infusion
(C) Hydrochlorothiazide plus saline infusion
(D) Mannitol plus saline infusion
(E) Spironolactone plus saline infusion
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Katzung
Diuretic therapy of hypercalcemia requires a reduction in cal cium reabsorption in the thick ascending limb, an effect of loop diuretics. However, a loop diuretic alone would reduce blood volume around the remaining calcium so that serum calcium would not decrease appropriately. Therefore, a saline infusion should accompany the loop diuretic. The answer is B.