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Gabe's Locomotor > Drugs affecting bone > Flashcards

Drugs affecting bone Flashcards

1
Q

What does denosumab do?

A

RANK-L inhibitor

Reduces osteoclast activity

Increases bone density in post-menopausal women

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2
Q

What does raloxifene do?

A

Agonist at oestrogen receptors in bone and CV tissue

Antagonist at oestrogen receptors in breast and uterus

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3
Q

What is a common RANK-L inhibitor?

A

Denosumab

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4
Q

What is a common oestrogen receptor modulator used in bone disorders?

A

Raloxifene

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5
Q

What do bisphosphonates do?

A

Incorporated into bone ECM during mineralisation

Inhibit recruitment of oestoclases

Promote apoptosis of osteoclasts

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6
Q

What are the disadvantages of bisphosphonates?

A

Poorly absorbed

Oesophagitis risk

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7
Q

Do oestrogen receptor modulators increase bone mass?

A

No

They just maintain mass and slow loss

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8
Q

What is the acute effect of PTH?

A

Promotes osteoblast development and activity

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9
Q

What is the chronic effect of PTH?

A

Promotes oesteoclast activity

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10
Q

What are oral calcium salts used for?

A

As adjunctive therapy in osteoporisis

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11
Q

What are the side effects of oral calcium salts?

A

GIT disturbances

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12
Q

What is VitD used in the treatment of?

A

Deficiency states (Rickets and osteomalacia)

Endocrine dysfunction (hypoparathyroidism)

Chronic renal disease (inability to generate calcitriol)

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13
Q

What are the 2 available forms of VitD as a therapeutic?

A

VitD2 (for liver conversion)

Calcitriol (biologically active)

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14
Q

When is synthetic calcitonin (salcatonin) given?

A

In hypercalcaemia associated with neoplasia

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15
Q

What is salcatonin?

A

Synthetic calcitonin

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16
Q

What do processes that affect bone remodelling preferentially affect?

A

Trabecular bone

E.g. femoral neck and vertebral bodies

17
Q

Where is VitD converted to calcitriol?

A

Kidney

18
Q

What are the effects of calcitriol?

A

Increased intestinal absorption Ca2+

Decreased renal excretion Ca2+

Increased osteoclast activity

19
Q

How does PTH increase plasma Ca2+

A

Increases calcitriol synthesis and reduces renal Ca2+ excretion

20
Q

What is osteoporosis?

A

Reduction in bone mass more than 2.5 standard deviations below the norm for healthy 30 year old woman

21
Q

What is osteopaenia?

A

Reduction in bone mass 1-2.5 standard deviations below the norm for healthy 30 year old woman

22
Q

What are the 3 bone antiresorptive agents?

A

Bisphosphonates

Selective oestrogen receptor modulators

RANKL inhibitors

23
Q

What are the 4 bone anabolic agents?

A

PTH

Oral calcium

Oral vitamin D analogues

Calcitonin

Gabe's Locomotor (9 decks)

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