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Endo II > Bone Pharm > Flashcards

Bone Pharm Flashcards

1
Q

Hormones

A

Teriparatide

calcitonin

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2
Q

Vit D

A

choecalciferol (D3)
ergocalciferol (D2)
Calcitriol

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3
Q

Estrogen R modulators

A

Raloxifene

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4
Q

Bisphosphonates

A

Alendronate

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5
Q

MABs

A

denosumab

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6
Q

appendicular bone

A

80% of bone mass

mostly compact cortical bone

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7
Q

axial bone

A

trabecular

alteration in bone turn-over occur here

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8
Q

OPG

A

decoy R for RANKL
produced by osteoblasts
suppressed by estrogen deprivation

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9
Q

normal Ca

A

8.5-10.5

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10
Q

normal Phosphate

A

2.5-4.5

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11
Q

PTH and bone

A 
increases activity and number of osteoclasts by binding osteoblasts which release RANKL which activates osteoclasts
inhibits sclerostin (inhibits osteoblasts) from osteocytes, but net effect is still bone break down
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12
Q

PTH and kiindey

A

increase Ca resorption
increases Phosphorous excretion
sitimulates vit D activation
increases Mg resorption

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13
Q

teleparatide

A

synthetic recombinant human parathyroid hormone

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14
Q

teleparatide MOA

A

continuous administration causes bone demineralization

intermittent promotes growth

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15
Q

uses of teleparatide

A

women w/Hx of osteoporotic fracture and failed other drug therapy
men with primary hypogonadal osteoporosis

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16
Q

ADRs teleparatide

A 
orthostatic hypotension
hypercalemia
dizziness, nausea
hyperuricemia
anggina
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17
Q

teleparatide CI

A

pts with increased risk of osteosarcoma: pagets, elevated alk phos, open epiphyses, prior radiation therapy of skeleton

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18
Q

Calcitriol actions

A

augments intestinal absorption and retention of Ca and phos
increases bone turnover by
-recruitment and activation of osteoclasts
-increasing RANKL and osteocalcin

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19
Q

otherwise healthy what type of vit D do you Tx with?

A

ergocalciferol or cholecalciferol

20
Q

liver dis what type of D do you Tx with?

A

25-hydroxy

21
Q

kindey dis what type of D do you Tx with?

A

calcitriol

22
Q

what can vit D be used to Tx

A

rickets
hypoparathyroidism
prevention and Tx of osteoporosis

23
Q

ADRs to vit D

A

hypercalcemia -> n/v constipation
hyperphosphatemia
arrhythmias and pancreatitis

24
Q

FGF23

A

inhibits 1,25 (OH)2D production and phosphate resorption in kidney
produced by osteocytes and osteoblasts

25
Q

calcitonin

A

decreases serum Ca and phos
inhibits osteoclasts
decreases Ca and Phos resorption in kidney

26
Q

uses of calcitonin

A

pagets
osteoporosis
hypercalcemia

27
Q

ADRs of calcitonin

A

nausea, hand swelling, urticaria, intestinal cramping

28
Q

estrogens

A

prevent bone loss post-menopause

SERM (raloxifene) less ADRs then E

29
Q

raloxifene ADRs

A

hot flashes
leg cramps
thromboemoblism (3x increased risk)

30
Q

CI of raloxifene

A

Hx of venous thromboembolism
CAD
strokes

31
Q

bisphosphonate mOA

A

analogs of pyrophosphonate with C
chelate Ca
incorporate into bone
decrease formation and dissolution of hydroxyapatite crystals and inhibit osteoclasts

32
Q

PK of bisphosphonates

A

must be taken on empty stomach 30 min before meal

must be sitting upright and taken with full glass of water

33
Q

uses of bisphos

A

osteoporosis
hypercalcemia of malignancy
pagets

34
Q

ADRs of bisphos

A

osteonecrosis of the jaw

subtrochanteric femur fractures

35
Q

Denosumab MOA

A

binds RANKL

mimics osteoprotegrin

36
Q

PK of denosumab

A

sub-q every 6 months

37
Q

denosumab ADRs

A

possible immunosuppression
risk of osteonecoris of jaw and subtrochanteric fractures (maybe)
transietn hypocalcemia

38
Q

cincalcet MOA

A

activated CaSR -> inhibits PTH secretion

39
Q

uses of cincalcet

A

secondary hyperparathyroidism

40
Q

hypercalcemia Tx

A 
saline diuresis +/- furosemide
bisphos
calcitonin (takes 4-6hrs)
IV phosphate (fastest, but must be very careful)
glucocorticoids
41
Q

hypocalcemia Tx

A

Ca (IV, IM, or PO)
If IV Ca gluconate preferred
Vit D

42
Q

hyperphosphotemia Tx

A
  • restrict dietary phosphate
  • phosphate binding gels (Ca)
  • aboid aluminum antacids
43
Q

primary hyperparathyroidism

A

surgery

44
Q

secondary hyperparathyroidism

A

vit D

cinacalcet

45
Q

hypoparathyroidism

A

Ca

Vit D

46
Q

pagets

A

calcitonin and bisphosphonates (only for 6 months at a time)

Endo II (15 decks)

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