E2: Endocrine Pt 3: BONE drugs, Pituitary, Vit D Flashcards
SERMS – raloxifene (Evista)…Activates _______ receptors in _____…Where does it NOT activate these receptors? How is that helpful?
estrogen…bone…does not activate in breast, less risk of cancer!
EVISTA is the only medicine proven to reduce both the risk of spinal fractures due to osteoporosis and the risk of invasive breast cancer in postmenopausal women with osteoporosis.
SERMS-raloxifene-EVISTA
SERMS, Ral-ox-ifine (Evista) Summary of effects: has ______ action on bone, there is an Absence of ______ bleeding, Absence of endometrial and ______ stimulation…Most common SIDE EFFECTS: _______ and Leg cramps
Anti-resorptive.. vaginal.. breast… Hot flashes
WHAT IS THE BEST AVAILABLE BONE BUILDING DRUG?
Bisphosohonate!
Bisphos Mech of Action: Increases _______ …Inhibits _______ activity
bone mineral density…. osteoclastic
Bisphos Mech of Action: inhibits bone ________….Inhibits formation, growth and dissolution of bone ________ crystals
resorption… hydroxyapatite
What do all the Bisphosphonates end in?
“-DRONATE”
What are the three Oral Bisphosphanates?
1.Alen-dronate (Fosamax) 2.Rise-dronate (Actonel 3.Iban-Dronate (Boniva)
What is the IV Bisphosphonate that is used BOTH for Tx AND Prevention of bone pathology…What is a DENTAL (rare) side effect?
ZOL-E-DRONIC ACID (zometa)….Osteonecrosis of the Jaw
Bisphosphonates have a poor ________, so take on empty stomach Water only (everything else decreases absorption by >___%) Remain upright for at least ___ minutes…No eating for at least ___ minutes
bioavailability…..60%!…30 minutes (both)!!
Bisphosphonates: 3 common side effects…
1.Erosive Esophagitis 2.Headache 3.GI distress
What is usually the indication for Bisphosphonates when Osteonecrosis of the Jaw occurs?
Cancers that have metastasized to bone (breast, prostate)
Pretty interesting: what is the normal half life of Bisphoshonates?
10 years! (so will probably be with you for 40+ years!
Most cases of jaw osteonecrosis are in patients undergoing chemotherapy with IV Bisphosphonates who also received _______; possible other risk factors
steroids
What are the 3 IV Bisphosphonates?
1.Pam-i-dronate (Aredia) 2.Zole-dronic Acid (Zometa) 3.Til-u-dronate (Skelid)
Hormones are produced by ______ glands and are transported by ______ to target cells
ductless….body fluids
What are the 4 therapeutic uses of Hormones?
- Replace 2.Diagnose 3.Stimulate 4.Inhibit
What are the 5 Hypothalamic Releasing Hormones? (just abbreviations will do…) ALSO, what is the ONLY one used as a drug?
1.GnRH 2.TRH 3.CRH 4.GHRH 5.SRIF…GnRH is the only one used as a drug
GnRH is the only Hypolathamic Releasing Hormone used as drug…it is used as a synthetic ______ (which has GREATER receptor affinity!)
analog
What is the INDICATION for the use of GnRH as a drug in women?
Ovulation induction in women with Primary Hypothalamic Amenorrhea (Fertility drug!)
The GnRH drug _______ is used as an OVULATORY stimulant.
CLOM-i-phene (CLOMid)
The GnRH drug CLOM-i-phene (CLOMid) Stimulates the release of pituitary ________ and _______.
luteinizing hormone (LH)….follicle stimulating hormone (FSH)
CLOM-i-phene (CLOMid) Action is at “______” (testes, ovaries) to induce gametogenesis and gonadal hormone production
“end organs”
What is the INDICATION for the use of GnRH as a drug in men?
to Tx idiopthic Hypogonadotropic Hypogonadism for achieving more Spermatogenesis
Which Anterior Pituitary Hormone is used to diagnose apparent adrenal dysfunction?
ACTH