Bone metabolism Flashcards
What are bisphosphonates used for?
Osteoporosis, Paget’s disease, hypercalaemia due to malignancies.
What is the mechanism of action of bisphosphonates?
Analogues of pyrophosphate that inhibit bone breakdown and resorption. They are taken up from the matrix by osteoclasts and inhibit recruitment and induce apoptosis of osteoclasts.
Directly stimulate osteocytes.
List the ADRs of bisphosphonates.
GI, MSK pain, headache
Osteonecrosis of the mandible (rare), increased risk with dental work and jaw trauma.
List the ADRs or raloxifene (SERM).
Hot flushes, thromboembolism, dizziness, GI upset and leg cramps.
What is tibolone?
Steroid with oestrogen activity in bone and vagina and progesterone activity in the breast.
What are the common ADRs of tibolone?
Headache, dizziness, vaginal bleeding.
What is vitamin D used for?
Deficiency, Ricket’s, osteomalacia, hypocalaemia due to hypothyroidism.
What is the ADR of vitamin D?
Hypercalaemia
When are calcium salts used?
Deficiency, hypocalcaemia, hypothyroidism, prevention and treatment of osteoporosis.
What are common ADRs of calcium salts?
GI disturbances
What is teriparatide?
Peptide with human PTH hormone sequence that stimulates osteoblats
What are ADRs of teriparatide?
Nausea, dizziness, injection site reactions, joint pain, osteosarcoma
What is the mechanism of action of cincalcet?
Increases sensitivity of Ca2+ sensing receptors on PTH cells to reduce PTH secretion.
What are ADRs of cincalcet?
Nausea, vomiting
Hypocalcaemia
Drug interactions
What is denosumab?
Monoclonal antibody directed to RANKL and RANK to decrease osteoclast activation. SC injections
