<prompt> Answer this question truthfullyWhat is the medical treatment for hypoparathyroidism?  <response>: <reason> Pharmacologic medical therapies for hypoparathyroidism include calcium and Vitamin D3 supplementation. Severe hypocalcemia, a potentially life-threatening condition, is treated as soon as possible with intravenous calcium e.g. as calcium gluconate. Generally, a central venous catheter is recommended, as the calcium can irritate peripheral veins and cause phlebitis.Management guidelines for hypoparathyroidism are as follows:1 Management of Acute hypocalcemia Note1: IV calcium used for marked hypocalcemia 7.0 mgdL, hypocalcemia associated with signs and symptoms, and if patients unable to take or absorb oral calcium supplements. 1.1 Intravenous calcium supplementation Preferred regimen 1: Calcium gluconate 1 to 2 g in 50 mL of 5 dextrose over 10-20 minutes initially followed by maintenance by 50 100 mghour. Note1: 10 calcium gluconate is used which contains 90 mg of elemental calcium per 10 mL. Note2: 1 mgmL solution of elemental calcium is prepared as follows: Add 11 g of calcium gluconate 110 mL to 890 mL normal saline or 5 dextrose water making a final volume of 1000 mL. 11 g of calcium gluconate contains 990 mg of elemental calcium. Note3: Rapid infusion of calcium gluconate should not be used as it carries serious risk of cardiac dysfunction, including systolic arrest. 1.2 Parenteral vitamin D therapy Preferred regimen 1: Calcitriol 0.25 to 0.5 μg q12h 1.3 Intravenous Magnesium supplementation in case of hypomagnesia Preferred regimen 1: Magnesium sulfate 2g 16mEq as 10 solution, infused over 10 -20 minutes initially, followed by 1g 8 mEq in 100 mL infused over an hour.2 Conventional therapy for hypoparathyroidism 2.1 Oral calcium Preferred regimen 1: Calcium carbonate 40 elemental calcium better absorption with meals Alternative regimen 1: Calcium citrate 21 elemental calcium more effective in patients with achlorhydria and proton pump inhibitors use, worsening constipation 2.2 Vitamin D supplementation Preferred regimen 1: Calcitriol 0.25 to 2 μg q24h .75 μg administered in divided doses Preferred regimen 2: Cholecalciferol parent vitamin D3 Preferred regimen 3: Ergocalciferol parent vitamin D2 Alternative regimen 1: 1α-Hydroxyvitamin D alfacalcidol used outside the United States Alternative regimen 2: Dihydrotachysterol used outside the United States Note1: Serum calcium corrected for albumin, phosphorus, and creatinine concentrations should be measured weekly to monthly during dose adjustments, and twice annually once a stable regimen has been reached. Note2: 24 Hour urinary calcium and creatinine should be considered during dose adjustments and should be measured twice annually on a stable regimen to evaluate for renal toxicity. 3 Adjunctive Treatments 3.1 Diuretics 3.1.1 Thiazides Preferred regimen 1: Hydrochlorothiazide 2550 mg q12h minimum 25 mg to maximum 100 mg Alternative regimen 1: Chlorthalidone Note1: Thiazide diuretics are not advised in congenital hypoparathyroidism due to autoimmune polyendocrine syndrome type 1 in patients who have concurrent Addisons disease or in autosomal dominant hypocalcemia. 3.1.2 Potassium sparing diuretics Alternative regimen 1: Amiloride 2.5 to 5 mg q12h 3.2 Treatment of hyperphoshatemia Preferred regimen 1: Low phosphate diet Preferred regimen 2: Phosphate binders 3.3 PTH replacement Preferred regimen 1: Natpara rhPTH 50 μg SC q24h concomitantly decrease the dose of active vitamin D by 50 Note1: Monitor serum calcium and albumin concentrations every 37 days after initiation of therapy and after each dose change. 