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Pharm Final > Bone Drugs > Flashcards

Bone Drugs Flashcards

1
Q

What cells in what organ produce calcitonin?

A

parafollicular C cells of thyroid

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2
Q

What cells in what organ release PTH?

A

Chief cells of the parathyroid gland

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3
Q

What are the effects of PTH on plasma phosphate and calcium?

A

Decrease phosphate

Increase calcium

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4
Q

What are the effects of calcitonin on serum phosphate and calcium?

A

Decrease phosphate
Decrease calcium

(opposite of vit D)

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5
Q

moderate decline in what ion enhances PTH secretion?

A

Mg+2 - but if severe decrease -> decrease in PTH

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6
Q

What are the effects of active vitamin D on serum phosphate and calcium?

A

increase phosphate
increase calcium

(opposite of calcitonin)

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7
Q

What are the effects on bone of pulsatile PTH vs continued secretion?

A

pulsatile: bone formation
excess: bone resorption

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8
Q

which drug is a PTH analog and is used in the treatment of osteoporosis. How must it be given?

A

Teriparatide

give pulsatile to stimulate bone growth

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9
Q

Which drug is a RANKL inhibitor and is used in osteoporosis? How does it work? 1 Adverse effect?

A

Denosumab - monoclonal Ab binds RANKL and prevents it from stimulating osteoclasts

AE: increased risk of infections (same with all monoclonal Abs)

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10
Q

What is the difference between type I and type II Rickets?

A

Type I: defective 1alpha hydroxylase (dec calcitriol)

Type II: defective vit D receptor

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11
Q

Which drug is used to treat secondary hyperparathyroidism in patients with chronic renal disease and liver disease?

A

Calcitriol - vitamin D

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12
Q

What topical drug is used to treat psoriasis?

A

Calcipotriol - vitamin D

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13
Q

Overdose of vitamin D leads to what two major symptoms?

A

Hypercalcemia

Hyperphosphatemia

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14
Q

What are the two generic drug names for vit D3 and vit D2? what are they used for?

A

D3: Cholecalciferol
D2: Ergocalciferol

commonly added to calcium supplements and dairy products

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15
Q

What drug is given to patients with hyperphosphatemia in chronic renal failure? how does it work?

A

Sevelamer - binds dietary phosphate and prevents absorption

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16
Q

Which drug can be given IV to treat hypocalcemic tetany?

A

IV calcium gluconate

17
Q

Which drug can be given to counteract overdose of magnesium sulfate used in eclampsia?

A

Calcium gluconate

18
Q

What are the two important adverse effects of calcium gluconate? (1 when given IM, 1 when given IV)

A

IM: injection can cause necrosis and abscess
IV: can cause thrombophlebitis

19
Q

Which drug used to treat osteoporosis has been shown to increase bone mass and reduce spine fractures? How is it given?

A

Calcitonin

injection or nasal spray

20
Q

Which SERM is estrogen antagonistic in breast, but agonistic in bone and uterus? AE?

A

Tamoxifen (selective estrogen receptor modulator)

increased risk of endometrial cancer

21
Q

Which SERM is estrogen antagonistic in breast, agonist in bone and has no effect on endometrium?

A

Raloxifene (selective estrogen receptor modulator)

22
Q

Which SERM is approved for treatment of osteoporosis in post-menopausal women?

A

Raloxifene

23
Q

Which class of drugs is useful in treating osteoporosis, malignancy associated hypercalcemia, and Paget’s disease of the bone?

A

Bisphosphonates (the -dronates)

24
Q

What class of drugs inhibits osteoclastic activity by decreasing farnesyl pyrophosphate synthesis? How are they given?

A

Bisphosphonates (the -dronates)

IV or orally (less than 10% bioavailability orally)

25
Q

What drugs used to treat osteoporosis can cause erosive esophagitis?

A

Bisphosphonates (the -dronates)

oral ones: Alendronate and Risedronate

26
Q

Which drug is a calcium receptor agonist that leads to suppression of PTH synthesis and release in secondary hyperparathyroidism (chronic renal disease) and in patients with parathyroid carcinoma?

A

Cinacalcet

27
Q

Exposure to what can lead to new bone synthesis that is denser, but brittle?

A

Fluoride

28
Q

Which drug inhibits bone resorption in cancer-related hypercalcemia, but is nephrotoxic?

A

Gallium nitrate

29
Q

Which cytotoxic anticancer drug can be used to treat cancer-related hypercalcemia, but is hepatic and renal toxic?

A

Plicamycin

30
Q

Which class of drugs can prevent renal stones by decreasing the renal excretion of calcium?

A

thiazide diuretics

31
Q

what are the major signs of hypercalcemia?

A 
Stones (renal stones)
Bones (bone pain)
Groans (abdominal cramps)
Thrones (polyuria)
Psych overtones (fatigue, depression, anxiety)
32
Q

Which drug is used to treat osteoporosis, but if used long term can lead to osteomalacia?

A

Etidronate (>12 mo use) (bisphosphonate)

33
Q

Name 5 drugs that can cause osteoporosis

A 
Corticosteroids
Heparin
Lithium
Anastrazole
Alcohol

Pharm Final (20 decks)

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