A 58-year-old man with recently diagnosed primary hyperparathyroidism presents asymptomatic. Vital signs: BP 138/86 mmHg, HR 78 bpm, RR 16, temp 37°C. Labs show serum calcium 11.8 mg/dL, PTH 142 pg/mL, creatinine 0.9 mg/dL, and 24-hour urine calcium 180 mg/day. Bone density is normal. He denies nephrolithiasis, fractures, or neurocognitive symptoms. He declines surgery and seeks medical management. Which medication is most appropriate?

1. A)Bisphosphonates to inhibit bone resorption and lower calcium
2. B)Thiazide diuretics to promote renal calcium reabsorption
3. C)Calcimimetic agents (cinacalcet) to enhance calcium sensing and suppress PTH secretionGABARITO
4. D)High-dose vitamin D to suppress secondary hyperparathyroidism
5. E)Loop diuretics to increase urinary calcium excretion