Estrogen Agonist/Antagonist Facts

Question 1

What are Raloxifene’s indications?

Answer 1

Treatment AND prevention of osteoporosis in PM women

Reduction in risk of invasive breast caner in PM women with OP

Reduction in risk of invasive breast caner in PM women at high risk

Question 2

What is one major advantage of using Raloxifene as opposed to a bisphosphonate?

Answer 2

No incidence of ONJ or AFF

Question 3

What are Denosumab’s indications?

Answer 3

Treatment of PM women with OP at high risk for fractures

Treatment of OP in men receiving androgen deprivation therapy for prostate cancer

Treatment of OP in women receiving aromatase inhibitor therapy for breast cancer

Question 4

What is are some disadvantages of using Denosumab?

Answer 4

It is CI in patients with hypocalcemia

ONJ and AFF were reported with the use of this drug

Question 5

What are Teriparatide’s indications?

Answer 5

Increase bone mass in men with primary or hypogonadal OP at high risk for fracture

Men and women with glucocorticoid induced OP at high risk for fracture

Question 6

Which patients are potential candidates for Teriparatide therapy?

Answer 6

Patients with:

History of OP fracture
Multiple risk factors
Very low BMD (T score <-3.0)
Failed previous bisphosphonate therapy

Question 7

Which patients are CI for Teriparatide?

Answer 7

Patients that have received prior radiation to their skeleton

Question 8

If a patient presents with GERD or compromised esophageal motility, what meds would you consider?

Answer 8

IV bisphosphonates
SQ denosumab
Raloxifene

Question 9

Ifthe patient experiences ONJ, AFF from bisphosphonate therapy, what can you do?

Answer 9

Shorten the bisphosphonate therapy and consider sequential therapy => teriparatide or raloxifene