Drugs for Osteoporosis Flashcards
What are the Bisphosphonates?
- Alendronate and other -dronates
- Zoledronic Acid
What are the Bisphosphonates?
- Alendronate and other -dronates
- Zoledronic Acid
What are the Vitamin D’s?
- Ergocalciferol
- Cholecalciferol
What are the Vitamin D’s?
- Ergocalciferol
- Cholecalciferol
What is the Selective Estrogen Receptor Modulator (SERM)?
Raloxifene
What is the Selective Estrogen Receptor Modulator?
Raloxifene
What is the RankL (-)?
Denosumab
What is the RankL (-)?
Denosumab
What is the PTH Hormone?
Teriparatide
What is the PTH hormone?
Teriparatide
When are parenteral calcium salts given?
Severe hypocalcemia
What are possible general side effects of calcium salts?
GI, CNS and Renal dysfunctions
What form of Vitamin D/where is Ergocalciferol found?
D2 = Plant form
What form of Vitamin D/where is Cholecalciferol found?
D3 = sunlight form
What is the MOA for Calcitonin - Salmon?
(-) Osteoclasts to decrease bone resorption
What is better about the Calcitonin-Salmon form?
Longer half life and more potent than the natural form
When is Calcitonin-Salmon used?
For established osteoporosis
When is Calcitonin-Salmon NOT used?
NOT used for prevention of osteoporosis
What is the MOA for the Bisphosphonates and what are they?
- Alendronate and other -dronates and Zolendronic Acid
= analogs of pyrophosphate
==> (-) bone resorption when incorporated into bone
What class of drugs are analogs to pyrophosphate and (-) bone resorption by being incorporated into the bone?
Bisphosphonates
What are the adverse effects (3) of Alendronate and other -dronates?
- Esophagitis
- Jaw Osteonecrosis
- Atypical femur fractures
What are the adverse effects of Alendronate and other -dronates?
- Esophagitis
- Jaw Osteonecrosis
- Atypical femur fractures
What should you do to try and avoid the esophagitis that can be associated with Alendronate?
Take with water and wait 30 mins before eating or drinking anything else
How is Zolendronic Acid given?
IV 1X/year
What is good about Zolendronic Acid compared to other Bisphosphonates?
Avoids GI problems
What are the adverse effects (2) of Zolendronic Acid?
- Jaw osteonecrosis
- Kidney damage
MOA for Raloxifene
Estrogen agonist at bone
Estrogen blocker at breast and uterus
What are the adverse effects associated with Raloxifene?
Increased risk of DVT, Stroke and Pulmonary Embolism
When should you discontinue Raloxifene?
Before prolonged inactivity to prevent a DVT, stroke or pulmonary embolism
Should you take Raloxifene with pregnancy?
NO
What is the MOA for Teriparatide?
Increases bone formation
What drug increases bone formation?
Teriparatide
When Teriparatide is given in a pulsed fashion, what occurs?
Osteoblast activity dominates
When Teriparatide is given continuously, what occurs?
Osteoclast activity dominates
How is Teriparatide given?
Once daily by using pre-filled injectors
Denosumab (-) RANKL which causes what to occur in the cascade?
(-) RANKL
(-) NF-KB
(-) Osteoclast activation
(-) Bone resorption
How is Denosumab given?
Subcutaneous injection every 6 months
What are the adverse effects (3) of Denosumab?
- Delays fracture healing
- Increases fracture risk
- Jaw Osteonecrosis
What are the 1st line and 2nd line options for Osteoporosis?
1st = Bisphosphonates 2nd = Denosumab
What are the 1st and 2nd line agents for Osteoporosis?
1st = Bisphosphonates 2nd = Denosumab
