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Pharm U5 > 2) Parathyroid and Bone - U5 > Flashcards

2) Parathyroid and Bone - U5 Flashcards

1
Q

What is the class for Alendronate (Fosamax)

A

Bisphosphonate

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2
Q

What is the mechanism for Alendronate (Fosamax)

A

Reduce osteoclastic bone resorption

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3
Q

What are the therapeutics for Alendronate (Fosamax)

A

Hypercalcemia; osteoporosis; Paget’s disease of bone

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4
Q

What are the important side effects for Alendronate (Fosamax)

A

Esophageal irritation

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5
Q

What are the other side effects for Alendronate (Fosamax)

A

Iritis, myalgias, AFF long-term possibly

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6
Q

What are the miscellaneous for Alendronate (Fosamax)

A

Oral formulation; patient must be sitting upright, fasting, for 30 minutes; takes several days to see effect

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7
Q

What is the class for Risedronate (Actonel)

A

Bisphosphonate

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8
Q

What is the mechanism for Risedronate (Actonel)

A

Reduce osteoclastic bone resorption

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9
Q

What are the therapeutics for Risedronate (Actonel)

A

Hypercalcemia; osteoporosis; Paget’s disease of bone; prevention of fractures in osteogenesis imperfecta

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10
Q

What are the important side effects for Risedronate (Actonel)

A

Esophageal irritation

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11
Q

What are the other side effects for Risedronate (Actonel)

A

Iritis, myalgias, AFF long-term possibly

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12
Q

What are the miscellaneous for Risedronate (Actonel)

A

Oral formulation; patient must be sitting upright, fasting, for 30 minutes; takes several days to see effect

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13
Q

What is the class for Ibandronate (Boniva)

A

Bisphosphonate

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14
Q

What is the mechanism for Ibandronate (Boniva)

A

Reduce osteoclastic bone resorption

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15
Q

What are the therapeutics for Ibandronate (Boniva)

A

Hypercalcemia; osteoporosis; Paget’s disease of bone; prevention of fractures in osteogenesis imperfecta

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16
Q

What are the important side effects for Ibandronate (Boniva)

A

Esophageal irritation

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17
Q

What are the other side effects for Ibandronate (Boniva)

A

Iritis, myalgias, AFF long-term possibly

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18
Q

What are the miscellaneous for Ibandronate (Boniva)

A

Oral and IV formulations; patient must be sitting upright, fasting, for 30 minutes; takes several days to see effect

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19
Q

What is the class for Pamidronate (Aredia)

A

Bisphosphonate

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20
Q

What is the mechanism for Pamidronate (Aredia)

A

Reduce osteoclastic bone resorption

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21
Q

What are the therapeutics for Pamidronate (Aredia)

A

Hypercalcemia of malignancy; Paget’s disease of bone; prevention of fractures in osteogenesis imperfecta

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22
Q

What are the important side effects for Pamidronate (Aredia)

A

Fever, flu-like symptoms

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23
Q

What are the other side effects for Pamidronate (Aredia)

A

Iritis, myalgias, AFF long-term possibly

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24
Q

What are the miscellaneous for Pamidronate (Aredia)

A

Bypasses GI tract (given IV); takes several days to see effect for lowering calcium

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25
Q

What is the class for Zoledronic acid (Reclast)

A

Bisphosphonate

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26
Q

What is the mechanism for Zoledronic acid (Reclast)

A

Reduce osteoclastic bone resorption

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27
Q

What are the therapeutics for Zoledronic acid (Reclast)

A

Hypercalcemia of malignancy; Paget’s disease of bone; prevention of fractures in osteogenesis imperfecta

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28
Q

What are the important side effects for Zoledronic acid (Reclast)

A

Fever, flu-like symptoms

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29
Q

What are the other side effects for Zoledronic acid (Reclast)

A

Iritis, myalgias, AFF long-term possibly

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30
Q

What are the miscellaneous for Zoledronic acid (Reclast)

A

Bypasses GI tract (given IV); takes several days to see effect for lowering calcium

31
Q

What is the class for Cinacalcet (Sensipar)

A

Calcimimetic

32
Q

What is the mechanism for Cinacalcet (Sensipar)

A

Reduces PTH and serum calcium levels

33
Q

What are the therapeutics for Cinacalcet (Sensipar)

A

Secondary hyperparathyroidism from renal disease; parathyroid carcinoma; hypercalcemia in primary hyperparathyroidism not treatable by surgery

34
Q

What are the important side effects for Cinacalcet (Sensipar)

A

Vision changes, palpitations, dizziness, chest pains, headache

35
Q

What is the class for Calcitonin (Miacalcin)

A

Amino acid peptide

36
Q

What is the mechanism for Calcitonin (Miacalcin)

A

Increases urinary calcium excretion, inhibits bone reabsorption (modest effect)

37
Q

What are the therapeutics for Calcitonin (Miacalcin)

A

Short-term relief of hypercalcemia; Paget’s disease of bone

38
Q

What are the important side effects for Calcitonin (Miacalcin)

A

Minimal (e.g., rhinitis)

39
Q

What are the miscellaneous for Calcitonin (Miacalcin)

A

No longer recommended for use in nasal spray form because of increased cancer risk. Can still use SQ or IM. Tachyphylaxis in 2-3 days; often used to bridge treatment for other medication

40
Q

What is the class for Teriparatide (Forteo)

A

PTH analog

41
Q

What is the mechanism for Teriparatide (Forteo)

A

Short bursts given SQ, stimulating bone resorption and bone formation via osteoblasts

42
Q

What are the therapeutics for Teriparatide (Forteo)

A

Osteoporosis (high risk patients who have failed other treatments)

43
Q

What are the important side effects for Teriparatide (Forteo)

A

Transient mild hypercalcemia

44
Q

What are the miscellaneous for Teriparatide (Forteo)

A

Requires daily SQ injections; contraindicated in those with increased chance of osteosarcoma (e.g., Paget’s disease of the bone, radiation exposure)

45
Q

What is the class for Raloxifene (Evista)

A

Selective estrogen receptor modulator

46
Q

What is the mechanism for Raloxifene (Evista)

A

Selectively activates certain estrogen receptors, but blocks others

47
Q

What are the therapeutics for Raloxifene (Evista)

A

Osteoporosis

48
Q

What are the important side effects for Raloxifene (Evista)

A

Increase risk of hot flashes, DVT

49
Q

What is the class for Hydrocortisone; Prednisone (Deltasone)

A

Corticosteroids

50
Q

What is the mechanism for Hydrocortisone; Prednisone (Deltasone)

A

Decreases production of 1,25 vitamin D; may inhibit growth of neoplastic lymphoid tissue

51
Q

What are the therapeutics for Hydrocortisone; Prednisone (Deltasone)

A

Hypercalcemia from vitamin D intoxication, granulomatous diseases, hematologic malignancies

52
Q

What are the miscellaneous for Hydrocortisone; Prednisone (Deltasone)

A

Hydrocortisone given IV, prednisone orally

53
Q

What is the class for Denosumab (Prolia)

A

Monoclonal antibody

54
Q

What is the mechanism for Denosumab (Prolia)

A

RANK ligand inhibitor (targets early effect of osteoclasts on bone)

55
Q

What are the therapeutics for Denosumab (Prolia)

A

Osteoporosis

56
Q

What are the important side effects for Denosumab (Prolia)

A

Concern for rashes, myalgias; AFF possible

57
Q

What are the miscellaneous for Denosumab (Prolia)

A

Given SQ every 6 months; can be given at lower GFR levels

58
Q

What is the class for Raloxifene (Evista)

A

selective estrogen receptor modulator (SERM)

59
Q

What is the mechanism for Raloxifene (Evista)

A

Binds to ER and decreases bone resorption

60
Q

What are the therapeutics for Raloxifene (Evista)

A

Osteoporosis

61
Q

What are the important side effects for Raloxifene (Evista)

A

Exacerbates hot flashes; increased risk of DVT

62
Q

What is the class for Calcium carbonate

A

Phosphate binder

63
Q

What is the mechanism for Calcium carbonate

A

Binds phosphate

64
Q

What are the therapeutics for Calcium carbonate

A

Secondary hyperparathyroidism from renal disease

65
Q

What is the class for Calcium acetate

A

Phosphate binder

66
Q

What is the mechanism for Calcium acetate

A

Binds phosphate

67
Q

What are the therapeutics for Calcium acetate

A

Secondary hyperparathyroidism from renal disease

68
Q

What is the class for Sevelamer (Renagel)

A

Phosphate binder

69
Q

What is the mechanism for Sevelamer (Renagel)

A

Binds phosphate

70
Q

What are the therapeutics for Sevelamer (Renagel)

A

Secondary hyperparathyroidism from renal disease

71
Q

What is the class for Calcitriol; Paracalcitol (Zemplar); Doxercalciferol (Hectorol)

A

vitamin D analog

72
Q

What is the mechanism for Calcitriol; Paracalcitol (Zemplar); Doxercalciferol (Hectorol)

A

Binds to VDR and elevates serum calcium levels

73
Q

What are the therapeutics for Calcitriol; Paracalcitol (Zemplar); Doxercalciferol (Hectorol)

A

Secondary hyperparathyroidism from renal disease

74
Q

What are the miscellaneous for Calcitriol; Paracalcitol (Zemplar); Doxercalciferol (Hectorol)

A

Given orally daily or IV several times a week

Pharm U5 (5 decks)

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