Bone Mineralization part 2

Question 1

How do Bisphosphonates increase bone density?

Answer 1

Bisphosphonates increase bone density by inhibiting bone resorption, and osteoclastic function by inducing osteoclast apoptosis

Question 2

Bisphophonates all have what suffix?

Answer 2

-onate

Question 3

all of the currently available bisphosphonates have this complication of? Except which one? ****

Answer 3

gastric irritation (except etidronate).

Question 4

bisphosphonates are indicated for? (6)

Answer 4

1. osteoporosis
2. postmenopausal osteoporosis
3. glucocorticoid-induced osteoporosis
4. paget’s disease
5. bone metastases
6. cancer-induced hypercalcemia..

Question 5

Which two Bisphosphonates can only be given IV

Answer 5

Pamidronate and Zoledronate

Question 6

oral bisphosphonates are first line therapy for what?

Answer 6

primary and secondary prevention of fractures.

Question 7

rare but serious ADE of bisphosphonates?****

Answer 7

osteonecrosis of the jaw.

Question 8

Contraindications to the administration and use of bisphosphonates include? (3)

Answer 8

decreased renal function, esophageal motility disorder and peptic ulcers.

Question 9

Denosumab MOA?

Answer 9

binds to RANKL which prevents RANKL from binding to RANK thus inhibits osteoclast formation and activity.

Question 10

Indications for denosumab?

Answer 10

postmenopausal women or men with osteoporosis at high risk for fracture

Question 11

Contraindications to denosumab includes ?

Answer 11

hypocalcemia.

Question 12

Serious ADE of Denosumab

Answer 12

Osteonecrosis of the jaw has been reported with denosumab (Prolia).

Question 13

Fluroride ix?

Answer 13

prophylaxis of dental caries.

Question 14

Gallium nitrate is currenty FDA approved for?

Answer 14

the management of hypercalcemia of malignancy

Question 15

The most significant side effect of gallium nitrate is?

Answer 15

nephrotoxicity.

Question 16

The primary contraindication to using gallium nitrate is ?

Answer 16

severe kidney disease.

Question 17

What is the MOA of both Gallium Nitrate and Fluoride?

Answer 17

inhibition of osteoclast activity.

Question 18

MOA of Cinacalcet?

Answer 18

binds and sensitizes CaSR (calcium-sensing receptor) in parathyroid–> decreased PTH

Question 19

Cinacalcet is indicated for?

Answer 19

the treatment of secondary hyperparathyroidism in chronic kidney disease

Question 20

Cincalcet is contraindicated in?

Answer 20

patients with hypocalcemia.

Question 21

How do calcimimetics and Calcilytics differ

Answer 21

mimetics agonize the CaSR

lytics antagonize

Question 22

The net effect of furosemide?

Answer 22

is to decrease serum calcium levels by excreting calcium in the urine

Question 23

the main indication for the use of furosemide is?

Answer 23

in the treatment hypercalcemia.

Question 24

The principal application of hydrochlorothiazide in calcium homeostasis is?

Answer 24

in reducing renal calcium excretion at distal tubule

Question 25

Hydrochlorothiazide is indicated for?

Answer 25

idiopathic hypercalciuria

Question 26

thiazide diuretics are contraindicated in the treatment of ?

Answer 26

hypercalcemia.

Question 27

Calcium is absorbed best in what pH environment?

Answer 27

an acidic environment

Question 28

The absorption of calcium carbonate requires?

Answer 28

stomach acid

Question 29

calcium citrate protects against?

Answer 29

kidney stones

Question 30

Which Calcium supplement can be administered IV

Answer 30

Calcium gluconate

Question 31

which Ca supplement is used in children

Answer 31

calcium glubionate

Question 32

The most common adverse effect of calcium supplements is?

Answer 32

constipation

Question 33

What is always 1st line for hypercalcemia

Answer 33

Rehydration

Question 34

Corticosteroids are also helpful to reduce serum calcium levels because? (2 mechanisms)

Answer 34

they inihibit intestinal calcium absorption and renal calcium reabsorption.

Question 35

What inhibitor of osteoclast activity is used to treat hypercalcemia?

Answer 35

Bisphosphonates

Question 36

which diuretics are contraindicated in hypercalcemia?

Answer 36

thiazides

Question 37

What is the only FDA approved drug that stimulates bone formation?

Answer 37

Teriparatide