Bisphosphonates

Question 1

Which generations of bisphosphonates are used

Answer 1

2nd and 3rd generations

Question 2

Bisphosphonates - indications

Answer 2

Osteoporosis
Paget disease of the bone
Hypercalcemia
Metastatic cancer: osteolytic bone lesion

Question 3

Bisphosphonates - adverse effects

Answer 3

Esophageal erosion
Atypical femur fractures
Osteonecrosis of the jaw

Question 4

Bisphosphonates - contraindications

Answer 4

Dull, aching pain in the thigh or groin (may progress to fracture of the femur)

Question 5

Bisphosphonates - MOA

Answer 5

Absorb hydroxyapatite and become permanent parts of the bone structure (terminal half life is 10 years). Inhibits osteoclast activity by preventing them to attach to bone

Question 6

How are bisphosphonates administered?

Answer 6

Orally, but extremely low bioavailability. Taken in morning on empty stomach.

Question 7

2nd generation bisphosphonates (4 drugs)

Answer 7

Alendronate
Pamidronate
Risedronate
Tiludronate

Question 8

Which bisphosphonates may be adm IV? (3 drugs)

Answer 8

Pamidronate
Ibandronate
Zoledronic acid

Question 9

Pamidronate - indications

Answer 9

Hypercalcemia associated with cancer

Question 10

3rd generation bisphosphonates (2 drugs)

Answer 10

Ibandronate

Zoledronic acid