What is an initial treatment strategy for hypercalcemia?

In the management of hypercalcemia, the initial treatment strategy focuses on addressing the immediate physiological effects of elevated calcium levels. Hydration with saline is critical as it helps to dilute serum calcium levels and promotes renal excretion of calcium. Administering isotonic saline can also help to manage any potential dehydration that may have occurred. This is particularly important in cases of hypercalcemia associated with conditions like malignancy or prolonged immobilization, where fluid volume may be inadequate.

Additionally, the use of diuretics, typically loop diuretics like furosemide, can assist in further increasing calcium excretion once rehydration has been established. However, it is essential to note that diuretics should never be the first step in treatment without adequate hydration since they can exacerbate dehydration and worsen hypercalcemia if used inappropriately.

Other strategies, such as immediate parathyroidectomy, may be relevant in cases of primary hyperparathyroidism, but these surgical interventions are generally not part of the initial management. Long-term medication therapy, including bisphosphonates or calcitonin, may be implemented after stabilization, but are not immediate interventions used for acute hypercalcemia. Similarly, calcium supplements would exacerbate hypercalcemia and are