AGENTS THAT AFFECT BONE-MINERAL HOMEOSTASIS Flashcards
3 PRINCIPAL HORMONE REGULATORS OF CALCIUM AND PHOSPHATE HOMEOSTASIS
1.
2.
3.
Parathyroid hormone
Fibroblast growth factor 23
Vitamin D
PRINCIPAL HORMONE REGULATORS OF CALCIUM AND PHOSPHATE HOMEOSTASIS
Stimulates production of vitamin D in the kidney
Promotes both bone formation & resorption (with net effect of more on resorption to release more Calcium into the blood),
parathyroid hormone
PARATHYROID HORMONE
acts on osteoblast to induce formation of ____ which acts on osteoclast to increase remodeling/bone resorption
RANK ligand
HORMONE ON BONE AND MINERAL HOMEOSTASIS
Hormone produced by osteocytes in bone in response to calcitrol
Stimulate renal phosphate excretion
Results to hypophosphatemia
FIBROBLAST GROWTH FACTOR 23
FIBROBLAST GROWTH FACT 23
inhibits ____________ resulting to impaired calcium absorption and osteomalacia
vitamin D production
VITAMIN D
__________ is used for rickets/osteomalacia
__________ is used to treat psoriasis
__________ and ________is used to treat secondary hyperparathyroidism with chronic kidney disease
calciferol
calcipotiene/calcipotriol
doxercalciferol & paracalcitol
ESTROGENS
estrogens and selective receptor modulators (SERMs eg; ________) can prevent or delay bone loss in post-menopausal women
raloxifene
ESTROGENS
____________ have been developed to retain beneficial effect on bone and minimizing the deleterious effect on breast, uterus and cardiovascular system
SERM SELECTIVE ESTROGEN RECEPTOR MODULATORS
SELECTIVE ESTROGEN RECEPTOR MODULATORS
first SERM approved for prevention of osteoporosis; may reduce vertebral fractures – may actually reduce risk of breast Ca cancer
Raloxifene
NON-HORMONAL AGENTS
inhibits bone resorption, increase bone density, and reduce risk of fractures
BIPHOSPHONATES
OSTEOPOROSIS TREATMENT
the recombinant form of PTH
subcutaneous for 2 years
stimulates new bone formation
TERIPARATIDE
OSTEOPEROSIS TREATMENT
_________ inhibits RANKL (produced by osteoblast which stimulate osteoclastogenesis)
human monoclonal antibody
toxicity
subtrochanteric fracture
osteonecrosis of the jaw
DENOSUMAB
CALCIMIMETICS
_______- lowers PTH by activating the calcium-sensing receptor in the parathyroid gland
treatment for secondary hyperparathyroidism in chronic kidney disease and for the treatment of hypercalcemia in patients with parathyroid carcinoma
Cinacalcet
Other drugs with effects on Serum calcium and phosphate
_________ is an organic ion bound to two atoms of strontium, promotes osteoclast apoptosis and increases concentration of bone formation markers
_________ is effective in managing the hypercalcemia associated with some malignancies and possible paget disease
strontium nitrate
gallium nitrate
