Final Exam Flashcards - OP and Paget's
Osteoporosis
-Chronic, progressive disease of bone with loss of bone density and bone strength leading to increased bone fragility and risk of fractures
Osteoblasts vs. Osteoclasts
- Osteoblasts: responsible for bone formation
- Osteoclasts: Are responsible for bone resorption
Paget’s Disease of The Bone
- Progressive disease of bone caused by irregular activity of osteoblasts and osteoclasts
- Causes enlarged structurally weak bones
Treatment Goals For Osteoporosis and Paget’s
- Treatment goal for osteoporosis is to increase bone density and decrease risk of fractures
- Drugs used are antiresorptive agents (inhibit bone resorption), or anabolic agents (promote bone reformation)
Antiresorptive Agents
- Bisphosphonates
- Calcitonin
- Estrogen agonist
- RANK Ligand inhibitors
Anabolic Agents
-PTH analogs
Bisphosphonates MOA
- Inhibit osteoclast activity
- Categorized as nitrogen containing and non nitrogen containing
- Nitrogen containing bisphosphonates are the MOST POTENT
Pharmacokinetics of Bisphosphonates
- VERY poorly absorbed in the GI tract
- Oral bisphosphonates must be taken ON AN EMPTY STOMACH AT LEAST 30 MINUTES BEFORE THE FIRST MEAL OF THE DAY
Bisphosphonates Tech Note!
- Patients should sit up or stand for 30-60 minutes after taking medication
- Tabs should be taken with 6-8 ounces of water
- Calcium supplements must be avoided within 2 hours of bisphosphonate dose
Bisphosphonate ADR’s
- Painful swallowing
- Heartburn
- Diarrhea
- N/V
SERMs
-Indicated for the treatment of osteoporosis in postmenopausal women
SERMs (raloxifene) ADR’s
- Hot flashes
- Leg cramps-Peripheral edema
- Stroke
- DVT
Calcitonin
-Inhibits rate of turnover and causes excess calcium to be stored in the bone
RANK Ligand Inhibitors
-Inhibits osteoclast activation, decreases bone resorption, and reverses bone remodeling
PTH Analogs
- Increase rate of bone remodeling
- Thicken structural units of the bone
- Decrease osteoblast cell death
