View source for Phosphate binders and calcimimetic

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''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''
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'''Phosphate binders and calcimimetic''' (brand names Renvela, PhosLo, Sensipar) &mdash; Chronic kidney disease mineral agents; Phosphate binders (sevelamer, calcium acetate); calcimimetic (cinacalcet).

== Identification ==
* '''Therapeutic class:''' Chronic kidney disease mineral agents.
* '''Pharmacologic class:''' Phosphate binders (sevelamer, calcium acetate); calcimimetic (cinacalcet).

== Pharmacology ==
* '''Mechanism of action:''' Phosphate binders bind dietary phosphate in the gut; cinacalcet increases sensitivity of the parathyroid calcium receptor to lower parathyroid hormone.
* '''Onset / peak / duration:''' Phosphate control over time; cinacalcet lowers parathyroid hormone over days.
* '''Half-life / therapeutic level:''' Variable; monitor calcium, phosphate, and parathyroid hormone.

== Clinical use ==
* '''Indications:''' Hyperphosphatemia in chronic kidney disease (binders); secondary hyperparathyroidism (cinacalcet).
* '''Usual dose, route, frequency:''' Binders with each meal; cinacalcet PO daily with food.
* '''Maximum dose / adjustments:''' Titrate to phosphate, calcium, and parathyroid hormone.

== Safety ==
* '''Contraindications:''' Bowel obstruction (binders); hypocalcemia (cinacalcet).
* '''Black box warning:''' None.
* '''Interactions:''' Binders reduce absorption of many oral drugs (separate doses); cinacalcet with CYP interactions.
* '''Pregnancy / lactation:''' Use if needed.
* '''High-alert:''' No.

== Adverse effects ==
* '''Common side effects:''' GI upset, constipation or diarrhea; calcium acetate can raise calcium; cinacalcet causes nausea and hypocalcemia.
* '''Serious effects to report:''' Severe hypocalcemia (cinacalcet: numbness, tingling, muscle cramps, seizures), hypercalcemia (calcium acetate).
* '''Antidote / reversal:''' Calcium for cinacalcet hypocalcemia.

== Nursing process ==
* '''Assessment before administration:''' Calcium, phosphate, parathyroid hormone.
* '''Interventions during therapy:''' Give binders with meals; monitor calcium closely with cinacalcet.
* '''Monitor:''' Calcium, phosphate, parathyroid hormone.
* '''Evaluation / expected outcome:''' Controlled phosphate and parathyroid hormone.

== Patient teaching ==
* '''Patient teaching:''' Take binders with meals; report numbness or muscle cramps (cinacalcet).
* '''Notify provider if:''' Tingling, muscle cramps, seizures (low calcium), severe GI symptoms.
* '''Administration tips:''' Binders with food; separate other oral drugs.

[[Category:Potassium and Phosphate Binders, Calcimimetic]]