<prompt> Not useful for acute Hypercalcemia?Normal salineCalcitoninFurosemideBisphosphonates  <response>: Ans. is c i.e., Furosemide Treatment for hypercalcemia depends upono The underlying disease.o The severity of hypercalcemia.o The serum inorganic phosphate level ando The renal hepatic and bone marrow function. o Mild hvpercalcemias 3 mmoll 12 mgdl-Managed by hydration aloneo More severe hvoercalcemia3.2 to 3.7 mmoll 13 to 15 mgdl-Requires rapid correction measures other than hydration.It requires combination of approaches.o Life threatening hypercalcemia3.7 mmolL 15 mgdL-Requires emergency measures TreatementOnset of ActionDuration of ActionAdvantagesDisadvantagesMost Useful Therapies Hydration with salineHoursDuring infusionRehydration invariably neededVolume overloadForced diuresis; saline plus loop diureticHoursDuring treatmentRapid actionVolume overload, cardiac decompensation, intesive monitoring, eletrolyte disturbance, inconvenienceBisphosphonates Pamidronate1-2 days10-14 days to weeksHigh potency, intermediate onset of actionFever in 20, hypophosphatemia, hypocalcemia rarely jaw necrosisZolendronate1-2 days 3 weeksSame as for pamidronate may last longerSame as pamidronate aboveCalcitoninHours1-2 daysRapid onset of action; useful as adjunct in severe hypercalcemiaRapid tachyphylaxisSpecial Use therapies PhosphateOral24 hDuring useChronic management with hypophosphatemia; low toxicity if P 4 mgdLLimited use except as adjuvant or chronic therapyGlucocorticoidsDaysDays, weeksOral therapy, antitumor agentActive only in certain malignancies vitamin D excess and sarcoidosis; glucocorticoid side effectsDialysisHoursDuring use and 24-48 afterwardUseful in renal failure; onset of effect in hours; can immediately reverse life-theratening hypercalcemiaComplex procedure, reserved for extreme or special circumstances 