Bone metabolism

Question 1

First line drug treatment for osteoporosis

Answer 1

Bisphosphonates

Question 2

What Bisphosphonates are IV

Answer 2

Zolendronic acid, Ibandronic acid

Question 3

What else can be used other than bisphosphonates for OP

Answer 3

Denosumab, Tepiratide, HRT, Raloxifene

Question 4

How long is tepiratide treatment limited to?

Answer 4

24 months

Question 5

After how long should bisphosphonate treatment be reviewed?

Answer 5

5 years

Question 6

Which bisphosphonate needs to be reviewed after 3 years

Answer 6

zolendronic acid

Question 7

MHRA alerts regarding bisphosphonates

Answer 7

1. ONJ
2. ON external auditory canal
3. NOF #

Question 8

What conditions are bisphosphonates contraindicated in?

Answer 8

Oesphageal abnormalities, Hypocalcaemia

Question 9

How should patients take Bisphosphonates

Answer 9

swallow whole, plenty of water, sit upright 30 mins, empty stomach

Question 10

What is the most potent bisphosphonate?

Answer 10

Zolendronic acid

Question 11

What biological parathyroid analogue can be used in osteoporosis?

Answer 11

Teparitide

Question 12

What are the MHRA alerts regarding Denosumab

Answer 12

1. Atypical femoral #
2. ONJ - hypocalcaemia
3. ON ear canal
4. risk of hypercaleamia following discontinuation
5. more new malignancies compared to ZA for advanced malignancies