Tatalaksana

Hypoparathyroidism
 Acute hypocalcemia
medical emergency and demands
urgent treatment, whatever the
cause
Treatment of chronic hypocalcemia is
more dependent on the cause.
 In hypoparathyroidism the aim is not to
achieve normalization of the plasma calcium,
rather to render the patient asymptomatic with
a plasma calcium at or just below the normal
lower limit. The reason for this is that the
renal retention of calcium brought about
by PTH has been lost.
Makannya, usaha apapun yg dilakukan untuk
meningkatkna kadar kalsium plasma bisa
nyebabin hypercalciuria, with the risk of
nephrocalcinosis and renal stones.
 Tetapi intravenous calcium dapat
mengiritasi pembuluh vena, jd lebih
baik diinfus into a large vein or
through a central venous catheter.
 Most patients will not achieve adequate
control with such treatment. In those
cases it is necessary to use vitamin D or
its metabolites in pharmacological doses
to maintain plasma calcium.
The more potent analogs of vitamin D,
such as calcitriol or alfacalcidol, have the
advantage over highdose calciferol that it
is easier to make changes in therapy in
response toplasma calcium levels.
 Preparat Vit D
Mek. Kerja : Meningkatkan absorbsi
kasium di GI tract dgn cara
merangsang protein-protein
pengikat kalsium
Dosis : 4000IU/hari
ESO : Hiperkalsemi
 Chronic Hypocalcemia
Oral calcium: 1,5- 3 gram atau lebih per hari

Preparat vitamin D akan meningkatkan absorbsi

kalsium dari traktus gastrointestinal.
Preparat vitamin D short-acting (calcitriol).
Preparat vitamin D very long-acting (ergocalciferol)
tdk mahal dan maintenance mudah, tetapi cepat
menimbulkan intoksikasi vitamin D.

Correction of vitamin D deficiency: 50,000 IU

ergocalciferol for 6 to 8 weeks diikuti oleh
replacement doses of 800- 2000 IU/d.
 Diet tinggi kalsium, rendah fosfor.
DIPERBOLEHKAN:
Tablet oral garam kalsium, seperti kalsium glukonat,
dapat diberikan dalam bentuk suplemen diet.
Gel aluminium hidroksida atau aluminium karbonat
(gelusil, amphojel) diberikan sesudah makan utk ikat
fosfat ekskresi lewat GIT.
HINDARI:
Susu, kuning telur kalsium tinggi, tp tidak boleh krn
fosfor tinggi.
bayam garam oksalat garam kalsium tdk larut.
 Krn adanya iritabilitas neuromuskuler, penderita
yg mengalami hipokalsemia perlu kondisi
lingkungan yang:
bebas dari suara bising
hembusan angin yang tiba- tiba
cahaya yang terang
Gerakan yang mendadak
 Greenspan's Basic & Clinical
Endocrinology
Oxford Clinical Endocrinology