Drugs that Affect Bone and Mineral Homeostasis

Question 1

High dose PTH causes?

Answer 1

Increased bone resorption, hypercalcemia, and hyperphosphatemia

Question 2

Low intermittent doses of PTH causes?

Answer 2

Net increase in bone formation

Question 3

Signs and symptoms of excess PTH

Answer 3

Painful bones
Renal stones
Abdominal groans
Psychiatric overtones

Question 4

Used in rickets and osteomalacia

Answer 4

Ergocalciferol

Cholecalciferol

Question 5

Used in secondary hyperparathyroidism in CKD to lower serum PTH

Answer 5

Calcitriol (AE: causes hypercalcemia)

Paricalcitol: rarely precipitates hypercalcemia

Cinacalcet: suppresses PTH synthesis and release

Question 6

Used in psoriasis

Answer 6

Calcipotriene

Question 7

First line drug for Paget’s disease of bone

Answer 7

Calcitonin
Alendronate (Bisphosphonate)

Pamidronate- most useful for the treatment of hypercalcemia in Paget’s disease

Question 8

Used in hyperphosphatemia in CKD hypoparathyroidism, and Vitamin D intoxication

Answer 8

Sevelamer

phosphate binding resin

Question 9

Recombinant PTH used for the treatment of osteoporosis; acts through PTH receptors to produce a net increase in bone formation

Answer 9

Teriparatide

Question 10

MOA of denosumab

Answer 10

Binds to RANKL and prevents it from stimulating osteoclast differentiation and function

Question 11

Used for hyperparathyroidism

Answer 11

Cinacalcet (Calcimimetic)- activates the calcium-sensing receptor

Question 12

Routinely added to calcium supplements and milk for the purpose of preventing rickets in children and osteomalacia in adults

Answer 12

Cholecalciferol

Question 13

Long term use of this drug causes osteoporosis

Answer 13

Glucocorticoids

Question 14

MOA of bisphosphonates (eg. alendronate)

Answer 14

Suppresses the activity of osteoclasts and inhibits bone resorption

Question 15

Used for osteoporosis in postmenopausal women

Answer 15

Raloxifene (estrogen agonist effect in bones)