Fractures Flashcards
Remember: B, C, D
List the primary therapy used to treat bone fractures
- Taking primary therapies like:
bisphosphonates, calcitonin, and Vitamin D, to make the bone stronger - Taking pain and anti-inflammatory medicines
List the 3 classes of Drugs used to treat bone fractures
Bisphosphonates,
RANK-Ligand(L) inhibitor，
Parathyroid
Re: Bone Fractures
List the drugs, MOA, Rationale and A.E. for Biphosphonates
Recall: This drug is not just for bone fracture, it can also be used for?
This class of drug can also be used as a primary therapy to prevent bone fractures.
Drug: Alendronate, Risedronate (PO)
Class: Bisphosphonates
MOA: Structural analogs of pyrophosphate, a natural substance that inhibits bone breakdown
Rationale: First year of therapy has the most benefit to increase bone density. Subsequent years: plateau effect
A.E.:
- Nausea,
- dyspepsia (indigestion),
- diarrhoea,
- bone and back pain
Re: Bone Fractures
List the drugs, MOA, Rationale and A.E. for RANK-L inhibitor
Recall: There is a targeted group of patients for this drug
Drug: Denosumab (SC)
Class: Receptor activator of nuclear factor kappa-B (RANK) ligand inhibitor Monoclonal antibody targeting at RANK, responsible in bone resorption pathway
Rationale: Very targeted, new drug,
for post menopausal women at high risk of fractures and patients with bone tumour
A.E.: Fatigue, asthenia, hypophosphatemia, nausea, hypercholesterolemia, musculoskeletal pain and cystitis.
Note: Hypocalcaemia
Re: Bone Fractures
List the drugs, MOA, Rationale and A.E. for Parathyroid hormone analogue
Recall: Main disadvantage!
Drug: Teriparatide (SC)
Class: Parathyroid hormone analogue
MOA: Like endogenous PTH to increase bone formation
Rationale: Reserved for patients with high risk of bone fractures;
Disadvantage: got to give SC daily
A.E.: Dizziness, depression, insomnia, vertigo, rhinitis, increase cough, leg cramps, nausea, arthralgia
