Calcium pharmacology

Question 1

Sinacalcet

Answer 1

Sensitizes CaSR in PT gland to decrease PTH secretion
Used in hyperPTH
AE: hypocalcemia
Adjust does in liver failure

Question 2

Bisphosphonates (-dronate)

Answer 2

Inhibit osteoclast bone resorption by binding bone surface (pyrophosphate analogs), getting eaten by ‘clasts inhibiting their activity
Use: osteoporosis, hypercalcemia, Paget disease, metastatic bone disease, osteogenesis imperfecta
AE: pill esophagitis, jaw osteonecrosis, atypical stress fx
Contraindicated: hypocalcemia, swallowing d/o, bed ridden, and those with RENAL DZ

Question 3

Estrogen/Testosterone

Answer 3

E blocks osteoclasts development (M+F)

In men giving T can aromatize to E to do same

Question 4

SERMs

Answer 4

Tissue-dep. E agonism/antagonism
Raloxifene is used in osteoporosis (AE: hot flash, DVT)
Also protective by making more OPG

Question 5

Denosumab

Answer 5

Anti-RANK-L

Clasts can form but no activity

Question 6

Teriparatide

Answer 6

recombinant PTH to increase blastic activity
Use in severe osteoporosis, can actually cause bone GROWTH
NO in pt with prior cancer/ radiation
AE: hypercalcemia

Question 7

Vit D analogs
Cincalcet
Phosphate binders

Answer 7

Use in hyperPTH