Drugs for Osteoporosis Flashcards
What are two types of drugs that are used to treat osteoporosis?
SERMS and bisphosphonates
Osteoporosis Drugs: SERMS stand for
Selective estrogen receptor modulators
Osteoporosis Drugs: What are three types of oral bisphosphonates?
Fosamax, Acetonel, Boniva
Osteoporosis Drugs: Example of SERMS drug
Raloxifene
Osteoporosis Drugs: Raloxifene Function
Activates estrogen receptors in bone.
Osteoporosis Drugs: FDA approved Raloxifene for what use?
For prevention of osteoporosis in postmenopausal women
Osteoporosis Drugs: What does Raloxifene not do?
Does not activate estrogen receptors in breast, thus helping to prevent breast cancer
Osteoporosis Drugs: Raloxifene is primarily used by what population? Why?
Used by women with osteporosis risk who also have risk for breast cancer (therefore are unable/unwilling to take estrogen)
Osteoporosis Drugs: Raloxifene alternate name
Evista
Osteoporosis Drugs: Evista (Raloxifene) is the only medication to reduce what two events?
- Reduce risk for spinal fractures due to osteoporosis
2. Reduce risk of invasive breast cancer in postmenopausal women with osteoporosis
Osteoporosis Drugs: What does Evista (Raloxifene) not do?
Does not treat breast cancer, prevent it from returning, or reduce the risk of all forms of breast cancer.
Osteoporosis Drugs: Evista (Raloxifene) summary of effects (3)
- Anti-resorptive action on bone
- Absence of vaginal bleeding
- Absence of endometrial and breast stimulation
Osteoporosis Drugs: Evista (Raloxifene) side effects
Hot flashes, leg cramps
Osteoporosis Drugs: MOA of Bisphosphonates
- Target osteoclasts
- Inhibit osteoclast formation and activity
What are the three oral bisphosphonates?
- Alendronate
- Risedronate
- Ibandronate
Function of oral bisphosphonates
Prevention and treatment of osteoporosis
What are the three IV bisphosphonates?
Etidronate
Pamidronate
Zoledronic acid
Tiludronate
Function of IV bisphosphonates
Treatment of bone pathologies
What is the IV bisphosphonate that is used for osteoporosis prevention
Zoledronic acid
What are some challenges of bisphosphonates?
- Low bio availability
- Take with full glass of water only
- Use with calcium but at different times
- Remain upright for 30 minutes to 1 hour after taking
Common Side effects of bisphosphonates
- Erosive esophagitis
- Headache
- GI distress
Oral complication of bisphosphonates
Osteonecrosis of the jaw
When are IV bisphosphonates used in most cases?
Given at higher doses for chemotherapy for cancers that have metastasized to the bone.
What are three examples of bisphosphonates given for chemotherapy and other bone pathologies
- Etidronate disodium
- Pamidronate
- Tiludronate
- Zoledronic acid
Bisphosphonates: Etidronate disodium uses
Paget’s disease, hypercalcemia (malignancy)
Bisphosphonates: Pamidronate Uses
Hypercalcemia (malignancy), bone cancers
Bisphosphonates: Tiludronate uses
Paget’s Disease
Bisphosphonates: Zoledronic acid uses
Hypercalcemia (malignancy), bone cancers
What is a complication of Bisphosphonates that occurs due to long-term use?
Increase prevalence of atypical fractures, especially in mid-shaft long bone and femur fractures
Two functions of calcitonin
Greatest effect in patients with rapid bone turnover.
Relieves osteoporotic bone pain