Oncologic Emergencies Dr Karenza Alexis

If calcium >12 or symptoms

• Gallium nitrate- inhibits bone resorption
• Onset of action 24 to 48 hours
• 100-200 mg/m2/d IV over 24 hours for up to 5 days in volume replete non-oliguric patients
• Once calcium is normal, stop treatment but CONTINUE TO MONITOR for its continued effect
• AVOID use of nephrotoxic drugs
• Plicamycin (25 ug/kg)
• Direct osteoclast inhibitory effects, may also block Vit D and PTH activity
• Onset of action is 24-48 h
• Toxicity with repeated use: renal and liver toxicity, thrombocytopenia

Tumor Lysis Syndrome

• Metabolic triad of hyperuriciemia, hyperkalemia, hyperphosphatemia

• Can also lead to renal failure and hypocalcemia as secondary complications

• Chemotherapeutic agents cause cell lysis and cell death with release of intracellular components into the blood stream

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