All are TRUE about the management of Humoral hypercalcemia of malignancy (HHM), EXCEPT:
The management of HHM: Removal of excess calcium in the diet, medications, or IV solutions. Oral phosphorus (e.g., 250 mg Neutra-Phos 3-4 times daily) Saline rehydration - dilute serum calcium and promote calciuresis. Forced diuresis with furosemide or other loop diuretics can enhance calcium excretion. Bisphosphonates such as pamidronate (60-90 mg IV), zoledronate (4-8 mg IV), and etidronate reduce serum calcium. Dialysis in severe hypercalcemia. Calcitonin and mithramycin have little utility now. Calcitonin -when rapid correction of severe hypercalcemia is needed. Hypercalcemia associated with lymphomas, multiple myeloma, or leukemia respond to glucocoicoid treatment. Ref: Harrison, E-18, P-829
Oral phosphorus initially
Saline rehydration is used
Bisphosphonates are very effective
Steroids are not useful