Does not require immediate treatment
Advise to avoid factors that can aggravate<unk>  (thiazide diuretics, Li, volume depletion, prolonged inactivity, high Ca diet)
May not require immediate therapy; however, an acute rise may cause symptoms necessitating treatment as described for severe<unk>  (see below)
Patients are likely dehydrated and require saline hydration as initial therapy
Isotonic saline at 200-300 mL/hour; adjust to maintain urine output at 100-150 mL/hour
Consider adding calcitonin 4 units/kg SC or IV q12hr in patients w/ Ca >14 mg/dL (3.5 mmol/L) who are also symptomatic (lowers Ca w/in 2-4hr)
Tachyphylaxis limits use long term, but is a great choice for emergent cases
Give for severe<unk>  due to excessive bone resorption (lowers Ca within 12-48hr)
Pamidronate 90mg IV over 24 hours OR
Zoledronate 4mg IV over 15 minutes
Caution in renal failure, though bisphosphonates have been safely used in pts with pre-existing renal failure
Correct hypokalemia
Correct hypomagnesemia
Furosemide is NOT routinely recommended
Only consider in patients with renal insufficiency or heart failure and volume overload
Consider if patient:
Anuric with renal failure
Failing all other therapy
Severe hypervolemia not amenable to diuresis
Serum Calcium level >18mg/dL
Neurologic symptoms
Heart failure with reduced ejection fraction (unable to provide fluids)
Decrease Ca mobilization from bone and are helpful with steroid-sensitive tumors (e.g. lymphoma, MM)
Prednisone 60mg PO daily
Hypercalcemia of malignancy
Addison's disease
White phosphorus toxicity
Calciphylaxis
Hyperparathyroidism
Excess vitamin D
Hypoparathyroidism
Cerebral edema in DKA