In cases of malignancy-related hypercalcemia, what medication can be used for treatment?

Malignancy-related hypercalcemia occurs when cancer causes elevated calcium levels in the blood, often due to bone metastases or parathyroid hormone-related peptide (PTHrP) secretion by tumors. In this context, bisphosphonates are the first-line treatment option. They work by inhibiting osteoclast activity, which leads to reduced bone resorption and subsequently lowers serum calcium levels. Bisphosphonates such as zoledronic acid or pamidronate are particularly effective in this scenario.

Loop diuretics, while they can help promote renal excretion of calcium, are usually not considered a primary treatment for hypercalcemia alone and are more often used in conjunction with other treatments to manage fluid overload. Calcium channel blockers and magnesium supplementation do not effectively lower calcium levels and are not indicated for hypercalcemia management. Thus, bisphosphonates remain the preferred treatment due to their direct action on the underlying pathophysiology of malignancy-related hypercalcemia.