Bone Mineral Homeostasis Flashcards
Etidronic acid is a
Diphosphate which affects calcium metabolism
Etidronic acid inhibits what?
Ectopic calcification and slows done bone resorption and bone turnover
Are etidronic acid and alendronic acid indicated for use in pediatric patients?
No
Etidronic acid and alendronic acid should not be used in patients with a creatinine clearence of
Less than 35mL/min
Biphosphonates act as analogues of
Isoprenoid diphosphates lipids in the cell membrane
Biphosphonates inhibit what?
Farnesyl pyrophosphate synthase preventing the biosynthesis of isoprenoid lipids
Biphosphonates are esential for what?
Post translational GTPase signaling proteins
Patients who are taking biphosphonates may experience what symptoms?
Hypocalcemia, hypophosphatemia and upper GI events
What is calcium gluconate?
A sterile, nonpyrogenic supersaturated solution of calcium gluconate for IV use only
What are the indications for calcium gluconate?
Dietary supplement, cardioprotective agent in high blood potassium, antidote for magnesium sulfate toxicity
Calcium is essential for which systems?
Nervous, muscle and bone
Calcium gluconate plays a role in normal
Cardiac function, renal function, respiration, blood coagulation, cell membrane and capillary permeability
Calcium helps to regulate what?
Release and storage of neurotransmitters and hormones, the uptake and binding of amino acids, absorption of vitamin B12, and gastrin secretion
The salmon version of calcitonin is
A synthetic peptide 32 residues long
The human version of calcitonin is
32 amino acid single chain polypeptide
For colonic administration
For people who have antibodies against salmon calcitonin
What are the indications for calcitonin?
Symptomatic Paget’s disease for patients unresponsive to alternate treatments or intolerant to such treatments
Emergency situations when calcium levels need to be lowered
Patients with azotemia
Post menopausal osteoporosis in women more than 5 years post menopause
What is the MOA of calcitonin?
Binds to the calcitonin receptor (found primarily on osteoclasts) which then enhances the production of vitamin D enzymes leading to greater calcium retention and enhanced bone density. Binding of calcitonin to its receptor activates adenylyl cyclase and the phosphatidyl-inositol-calcium pathway
Is salmon calcitonin recommended in nursing mothers?
No
Because of its protein structure, salmon calcitonin may induce a
Allergic reaction
The range between therapeutic and toxic doses is quite narrow in vitamin D resistant
Rickets
The administration of thiazide diuretics in patients with hypoparathyroidism who are also being treated with vitamin D can result in
Hypercalcemia
Vitamin D is indicated for?
Hypoparathyroidism, refractory rickets, familial hypophosphatemia
Vitamin D3 or D2 is hydroxylated to what in the liver?
25-hydroxyvitamin D
In the kidney, what version of vitamin D is produced?
1,25-dihydroxyvitamin D
