PAGE 17
HIV NUTRITION UPDATE
VOLUME 7, ISSUE 2
(Continued from page 16)
 
Time to peak excretion

C AMP- During the first 30 minutes postinfusion.

Phosphate- During the second 30 minutes postinfusion.

General Dosing Information

Hypocalcemia will stimulate parathyroid hormone secretion in patients with pseudohypoparathyroidism but not with hypoparathyroidism. Since hypocalcemia increases the contrast between iPTH values, iPTH is best measured when serum calcium is below normal, either before treatment is begun or after a brief period of less intensive therapy.

Teriparatide should not be administered in repeated doses for recurrent or chronic use, as in the treatment of osteoporosis.

NOTE: Teriparatide is not commercially available in the U.S.

Adverse Effects

Renal- Calcium clearance is reduced and tubular phosphate reabsorption is inhibited, thereby increasing phosphate excretion. Parathyroid hormone indirectly increases the intestinal transport of calcium by increasing renal 1,25-dihydroxyvitamin D3 production, and increases sodium and potassium excretion. These renal effects may be due to a direct action of the hormone on its receptors.
Skeletal- Initial effect on bone is to promote an increased rate of release of calcium from bone into the blood, possibly mediated by an effect on osteocytes or osteoclasts.
 
"Initial effect on bone is to promote an increased rate of release of calcium from bone into the blood, possibly mediated by an effect on osteocytes or osteoclasts."

References
 
  • Teriparatide product information (Parathar-Rhone Poulenc Rorer, U.S.). Revised 11/91.
  • Furlong R, Seshadri M, Wilkinson M. Clinical experiences with human parathyroid hormone 1-34. Aust NZ J Med 1986; 16: 794-8.
  • Mallette L. Synthetic human parathyroid hormone 1-34 fragment for diagnostic testing. Ann Int Med 1988; 109: 800-4.
  • Drugs.com Drug Database.  Accessed July 2002.
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9/23/2002