Hypercalcemia causes/symptoms

Calcipotriol is a vitamin D3 derivative which is used as a topical agent in the treatment of psoriasis. Although not completely elucidated its mechanism of action seems to be based on inhibition of the proliferation and stimulation of the differentiation of epidermal keratinocytes. Adverse effects include irritation of the skin but also urticarial reactions. Calcipotriol has 100 fold less vitamin D activity as its active vitamin D3 metabolite calcitriol. However, calcipotriol in overdose can cause symptoms of hypercalcemia. 

Sodium and water retention may also occur with androgen or anabolic steroid administration, causing die patient to become edematous, hi addition, otiier electrolyte imbalances, such as hypercalcemia, may occur. The nurse monitors the patient for fluid and electrolyte disturbances (see Chap. 58 for signs and symptoms of electrolyte disturbance). 

Clearly, the dosage of a calcium supplement must be determined by the specific needs of each individual. Excessive doses must also be avoided because they may produce symptoms of hypercalcemia, including constipation, drowsiness, fatigue, and headache. As hypercalcemia becomes more pronounced, confusion, irritability, cardiac arrhythmias, hypertension, nausea and vomiting, skin rashes, and pain in bones and muscle may occur. Hypercalcemia is a cause for concern because severe cardiac irregularities may prove fatal. 

Recurrent focal neurological symptoms are occasionally caused by hypercalcemia... 

Adverse reactions Excess of 40,000 IU results in hypervitaminosis D and may cause hypercalcemia (an elevated serum calcium level). Early symptoms of toxicity are anorexia, nausea, and vomiting. 

HYPERCALCEMIA The degree and rapidity of onset of hypercalcemia largely dictate the extent of symptoms. Chronic elevation of serum Ca to 12-14 mg/dL (3-3.5 mM) generally causes few manifestations, whereas an acute rise to the same level may cause marked neuromuscular manifestations by increasing the threshold for nerve and muscle excitation. Symptoms include fatigue, weakness, anorexia, depression, diffuse abdominal pain, and constipation. 

HYPERVITAMINOSIS D The acute or chronic administration of excessive amounts of vitamin D can cause hypervitaminosis D and hypercalcemia. The amount of vitamin D necessary to induce this condition varies widely. As an approximation, prolonged daily ingestion of 50,000 U or more can cause poisoning. The signs and symptoms are those associated with hypercalcemia. 

PTH antagonists may also have diagnostic value. Since PTH plays a role in the minute-to-minute regulation of blood calcium levels, short-term administration of a PTH antagonist may cause a rapid reduction in blood calcium levels in hypercalcemic patients if the hypercalcemia is due to elevated PTH levels. Similarly, short-term amelioration of possible symptoms of hypercalcemia (such as lethargy, cognitive defects) may help pinpoint the etiology of the symptoms (i.e. hyperparathyroidism vs. other disorders). 

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