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Pharmacology > Exam5- Osteoporosis > Flashcards

Exam5- Osteoporosis Flashcards

1
Q

RANKL

A

on osteoblasts and activates osteoclasts

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2
Q

Osteoprotegerin

A

binds to RANKL
prevents interaction of osteoclasts and blasts
-this is how estrogen limits bone resorption

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3
Q

Vitamin D

A

(+) Ca2+ absorption

(+) bone resorption and then eventually bone growth

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4
Q

Parathyroid hormone

A

(+) conversion of vit. D to calcitrol
(+) osteoblasts AND osteoclasts to bone remodel
(+) renal resorption of Ca2+

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5
Q

calcitonin

A

(-) intestinal absorption and renal reabsorption of Ca2+
(-) osteoclasts
(-) reduces circulating calcium

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6
Q

calcitrol effects

A

=potent vitamin D (D3)

(+) Ca2+ release from bone
(-) Ca2+ elimination from kidney
(+) Ca2+ absorption in Gi

NET EFFECT IS BUILDING BONE

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7
Q

vitamin d deficiency =

A

hypocalcemia/demineralization of bone
kids=rickets
adults=osteomalacia

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8
Q

vitamin D deficiency treatmetn

A

suplements
vitamin D2 (ergocalciferol)
Vitamin D3 (cholecalciferol)
-take with Ca2+ supplements

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9
Q

PTH effects on bone depend on___

A

concentration and pattern

  • low concentration/intermittent = greater effects on osteblasts =BONE GROWTH
  • high concentration/constant = greater effects on osteoclasts =BONE RESORPTION
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10
Q

teriparatide

A

recombinant PTH1-34 used for treatment of osteoporosis

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11
Q

glucocorticoids

A

(-) bone mineralization
(-) vitamin D effects
PROMOTE OSTEOPOROSIS
-DONT TAKE FOR MORE THAN 2 WEEKS

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12
Q

___ causes osteoporosis

A

estrogen, calcium of vitamin D deficiency and chronic glucocorticoid therapy

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13
Q

treatment of osteoporosis

A

-diet
-active livestyle
-bone density tests
supplements
-calcium, vitamin D
medications
-anti-resorptive meds
-anabolic drugs

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14
Q

anti-resoprtive medication lists

A 
Hormone Replacement Therapy
SERMs
Salmon calcitonin
bisphosphonates
denosumab
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15
Q

anabolic drugs lists

A

teriparitide

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16
Q

estrogen and progestin HRT drugs

A

permarin- estrogens only (only in women without uteruses)
prempro- estrogens and progestin
=increas OPG
-not first line choice in post menopausal women due to risk of stroke, heart disease, and breast cancer

17
Q

SERMs

A

Selective Estrogen Receptor Modulators
=raloxifene
=antagonist at estrogen receptor (reduces breast cancer risk)
=antagonist at estrogen receptor in uterus (no risk for reproductive cancer when administered without progestin)
=partial agonist at estrogen receptors that regulate resorption (protect against osteoporosis)
=risk for blood clots and strokes similar to HRT
-NOT FIRST LINE DRUGS FOR MANAGING OSTEOPOROSIS

18
Q

Salmon calcitonin

A

-nasal spray
-peptide secreted by parafollicular cells of the thyroid
-salmon has longer half-life
-inhibits osteoclasts and therefore (-) bone resorption
SECOND CHOICE DRUG because they’re less effective long term than estrogens and bisphosphonates

19
Q

side effects of salmon calcitonin

A

five year risk for cancer increased…

20
Q

bisphosphonates

A

(-) bone resorption by osteoclasts
FIRST CHOICE DRUGS FOR PREVENTION AND TREATMENT OF OSTEOPOROSIS
-reduces bone density and reduces fractures over 5 years

21
Q

bisphosphonates adverse effects

A 
bisphosphonate-associated osteonecrosis
=avascular necrosis
-exclusively in jaw
-disrupt the capillary network
-60% of cases preceded by tooth extractions
22
Q

bisphosphonates drug lists

A

alendronate
risedronate
ibandronate
zoledronic acid

23
Q

denosumab

A

-monoclonal antibodies that targets the RANKL
-equal efficacy with bisphosphonates and teriparatide
side effects= increased risk for infection and skin reaction
-indicated when other medications are not effective or tolerated or cases of very high risk of fracture

24
Q

teriparatide

A 
=recombinant form of PTH1-34
-sc administration
-selectively produces PTH effects on bone growth
-increases bone density
used in cases:
1. bone has been fractured/low density
2. bone density is lost when receiving other antiresorptive treatment
-hypothetical risk for  osteosarcomas

Pharmacology (11 decks)

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