Drugs for Osteoporosis

Question 1

what are the objectives of treatments?

Answer 1

1. Prevent bone breakdown (inhibit osteoclasts)
2. Stimulate bone build up
   - stimulate osteoblasts
   - Modify osteocyte activity

Question 2

What is the treatment of osteoporosis?

Answer 2

Bisphosphonates

Question 3

Explain the mechanism of action of bispohosphonate?

Answer 3

inhibits osteoclast action inhibiting an enzyme

Question 4

Describe the direction of how to take bisphosphonate?

Answer 4

• Morning
• full of glass of water
• Standing up and remain upright
• No food for 30mins

Question 5

What are the severe SE of bisphosphonates?

Answer 5

• Contact stomatitis
• Oesophageal ulcer
• Necrosis of the Jaw

Question 6

Explain is there any additive drug that may be taken alongside bisphosphonates that help reduce that fracture risk?

Answer 6

PPI

Question 7

IV zoledronate

Answer 7

Given IV

reduced fractures- HIP,spine - reduced mortality

Question 8

what is Densoumab and how does it work?

Answer 8

-Human monoclonal antibody
-Binds to RANK ligand
with high specificity&affinity
-no complement activity

Question 9

Explain the properties of the denosumab?

Answer 9

• Rapidly absorbed
• Long half life- 6 monthly injection
• cleared reticuloendothelial system - no renal involvement
• Reduces spine and hip fractures

Question 10

Explain the treatment options for osteoporosis as anabolic treatment?

Answer 10

• SC PTH 1-34
• Daily s/c of injection
• pulse of PTH- anabolic to bone
• reduces fractures

Question 11

What are the other options for osteoporosis?

Answer 11

HRT for women
Estrogen receptor modulator
Testosterone