Drugs in the management of ask disorders Flashcards
Week 3
Osteoporosis:
Reduced bone density
Osteoclasts > Osteoblasts
What does oestrogen inhibit in the body?
PTH (parathyroid hormone)
Which are multinucleated: osteoblasts or osteoclasts?
Osteoclasts
Osteoclasts are found where in the bone?
Lacunae
3 things osteoblasts produce:
- Rank-L
- M-CSF (macrophage-colony stimulating factor)
- OPG (oestroproterigin)
OPG is also known as…
Osteoclastogenesis inhibitory factor
What does RANK-L do?
Binds to osteoclast precursor causing its activation
What is the osteoclast ceiling zone marked by?
Integrins
Bisphosphonates have 2 R groups, what are their functions?
R1 = mode of action, nitrogen-containing or non-nitrogen containing R2 = pharmacokinetics
BPs reduce osteoclast activity by (3):
- Reduce osteoclast progenitor development
- Reduce osteoclast recruitment
- Increase osteoclast apoptosis
Widest side-effect of BP therapy:
Osteonecrosis of the jaw
SERM =
Selective-oestrogen receptor modulator
Raloxifene, tamoxifen =
SERM
Calcitonin MOA =
Elevates osteoblast activity
PTH MOA =
Increase osteoblast activity
How can RA be targeted?
NSAIDs Steroids DMARDs Biological agents Immunosuppression (severe disease)
Name a chronic adverse effect of long-term steroid use:
Cushing’s syndrome due to prolonged exposure to cortisol.
Name 3 DMARDs used in RA:
Hydroxycholorquine
Methotrexate
Sulfaslszine
What do you need to take with methotrexate?
Folic acid supplement
When can you not take methotrexate?
Pregnant (teratogenic)
What else if sulphasalazine used to treat?
Crohns disease
Side effect of sulphasalazine
Lowers sperm count
What else is chloroquine used to treat?
malaria
Name some biologic therapies for RA:
Adlimumab
Etanercept
Ingliximab
Rituximab
Adalimumab =
Anti-TNF alpha drug.
Name 2 ‘agents of last resort’ used in RA:
- Cyclophophamide
2. Ciclosporin
Hydroxyapetite =
Ca2+ and PO4-
Bone is arranged in
Osteons
Blood in osteons =
Haversian canals and volkmanns canals