DLA18- Bone Homeostasis Flashcards

1
Q

(1) is most common cause of hypercalcemia

(2) is choice treatment for hypercalcemia

A

1- hyperparathyroidism

2:
IV saline
loop diuretic (furosemide)

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2
Q

Hypocalcemia:

  • (1) most common cause
  • (2) signs, symptoms
  • (3) Tx
A

1- iatrogenic (parathyroidectomy w/ thyroidectomy)

2- tetany, carpo-pedal spasm, Chvostek’s sign

3- IV Calcium gluconate (preferred as CaCl would => venous sclerosis)

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3
Q

list Bisphosphonates by generation

A

(for osteoporosis)
1st- Etidronate

2nd- Alendronate, Pamidronate (10-100x potent)

3rd- Risedronate, Zoledronate (10000x potent)

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4
Q

Bisphosphonates are analogs of (1).

-(2) and (3) are main MOAs

A

1- pyrophosphate

2- induce osteoclast apoptosis
3- inhibits cholesterol biosynthetic pathway

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5
Q

besides osteoporosis, bisphosphonates are also used for ______, explain

A

malignancy-associated hypercalcemia: Ca chelator

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6
Q

______ is RANKL inhibitor, describe dosing and route of administratoin

A

Denosumab:

  • post-menopausal osteoporosis
  • SQ every 6 mos
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7
Q

______ is the PTH analog for male and female osteoporosis

A

Teriparatide:
-only anabolic / bone building agent –> inc osteoblast activity

  • alternate for previously failed Tx
  • SQ injection
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8
Q

______ are the anti-breast cancer agents that can be used to treat osteoporosis

A
SERMs: selective estrogen receptor modulator
Raloxifene:
-bone, liver agonist
-inactive in uterus
-breast antagonist

Tamoxifen-

  • bone, liver, uterus agonist
  • breast antagonist
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9
Q

______ is a hormone Tx for osteoporosis that is not currently recommended

A

Calcitonin – PTH antagonist

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10
Q

Paget’s Disease:

1st line, 2nd line, 3rd line Tx

A

1st- bisphosphonates

2nd- calcitonin

3rd- plicamycin: lethal antineoplastic antibiotic that inhibits RNA synthesis

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11
Q

Sevelamer:

  • (1) formulation
  • (2) MOA
  • treats (3)
A

1- sevelamer carbonate (not hydrochloride => metabolic acidosis)

2- chelated Phosphate

3- hemodialysis Pts

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12
Q

______ is phosphate binder

A

sevelamer

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13
Q

______ is selective vitD receptor agonists, include its use

A

Paricalcitol- secondary hyperparathyroidism

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14
Q

______ is Ca receptor agonist, indicate specific receptor and use

A

Cinacalcet:

  • enhances sensitivity of parathyroid calcium sensing receptor –> dec PTH
  • for CKD Pts with secondary hyperparathyroidism //// hemodialysis Pts
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15
Q

______ is synthetic vitD3, describe use

A

Calcipotriol:

  • apply topically (cream, ointment, foam) to Psoriatic plaques (or occasional Dermatitis)
  • regulates keratinocyte development –> inhibits proliferation and enhances differentiation
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16
Q

list the agents used for CKD with secondary mineral / bone disorders

A
  • Sevelamer (PO4- chelator)
  • VitD: doxercalciferol (prohormone), paricalcitol (agonist)
  • Cinacalcet (Ca receptor antagonist)
  • Fluoride
  • Gallium Nitrate
  • Thaiazides
  • Ca supplements