Bone Mineral Drugs

Question 1

Parathyroid Hormone (PTH)

Answer 1

-Increase Ca
-Decrease PO4
-Increase bone reabsorption
-Increase Vitamin D production

Question 2

Vitamin D

Answer 2

-Increase Ca
-Increase PO4
-Increase bone mineralization
-Increase GIT absorption

Question 3

Calcitonin

Answer 3

-Decrease bone reabsorption
(inhibitor of osteoclast activity)

Question 4

Teriparatide, Abaloparatide

Answer 4

MOA: binds to PTH-R

USE: osteoporosis

AE:
-Hypercalcemia
-Osteosarcoma

CI:
-Osteosarcoma (BBW)

NOT rec for over 2 years

Question 5

Cholecalciferol, Ergocalciferol, Calcitriol

Answer 5

Vitamin Ds

MOA: regulate gene trans. via Vit D-R

USE: supplement, osteoporosis

AE:
-Rare (hypercalcemia)

Take with Ca supplements

Question 6

Ca Carbonate, Ca Citrate

Answer 6

Carbonate: insoluble - take with meal

USE: osteoporosis phrophylaxis (w/VD)

AE: constipation

DDI: space drugs => 2 hrs apart

Question 7

Salmon Calcitonin

Answer 7

MOA: agonist at Calcitonin-R (GPCR) - inhibits bone resorption

USE: osteoporosis, hypercalcemia, Paget’s disease

AE:
-Rhinitis
-Allergic rxn (salmon)
-Flushing of face/hands
-Malignancy
-Hypocalcemia

CI: fish sensitivity

Question 8

Raloxifene

Answer 8

Levon has a Rolex HNT

MOA: estrogen modulator, increase bone formation, decrease bone resorption

USE: osteoporosis

AE:
-Hot flashes, night sweats
-Increase risk of thromboembolism

CI:
-Stroke, Thromboembolic disease (BBWs)

DDI: Levothyroxine (sep. by 12 hr)

Question 9

Alendronate, Risedronate, Ibaudronate, Zoledronic Acid

Answer 9

MOA: binds to hydroxyapatite, inhibit resorption, prevent osteoblast death

Give on empty stomach with water (wait 30 min)

USE: osteoporosis, hypercalcemia, Paget disease

AE:
-GI (reflux, ulcer, esophagitis)
-Flu like sx (fever, myalgias, arthralgia)
-Musculoskeletal pain

CI: renal, hypoCa, esophageal disorders

DDI: take apart from cationic drugs (antacids, mineral)
-NSAIDS

Question 10

Monitor Serum Ca / Cr

Answer 10

Alendronate, Risedronate, Ibaudronate, Zoledronic Acid

Question 11

Denosumab

Answer 11

Den ranks L for FOB

MOA: mAB to RANK L

USE: osteoporosis, hypercalcemia

AE: back pain / ONJ / femur fraction

Admin: SQ twice a year

Question 12

Decrease all 3: vertebral, non vertebral and hip fractions

Prevention and Treatment

Answer 12

Alendronate, Risedronate, Zoledronic Acid

Ibaudronate: JUST vertebral

Question 13

Decrease all 3: vertebral, non vertebral and hip fractions

Just Treatment

Answer 13

Denosumab

Question 14

Just vertebral: Prevent and Treat

Answer 14

Raloxifene

Question 15

Vertebral and Non Vertebral: Just Treat

Answer 15

Teriparatide