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Drug Action > Mineral Homeostasis and Bone Turnover > Flashcards

Mineral Homeostasis and Bone Turnover Flashcards

1
Q

What two specialized cells are responsible for skeleton remodeling?

A

Osteoblasts and osteoclasts

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2
Q

Bone remodeling usually occurs in response to what two factors?

A

Mechanical forces

Endocrine and paracrine factors

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3
Q

Bone is ___% organic component and ___% inorganic component

A

25%, 75%

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4
Q

What is the main inorganic compound of bone?

A

Hydroxyapatite

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5
Q

What are the main organic components of bone?

A

Cells and osteoid

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6
Q

What percent of body calcium is stored in the skeleton and in what form?

A

99%, hydroxyapatite

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7
Q

What vitamin helps enhance absorption of calcium in the body?

A

Vitamin D

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8
Q

Inherited deficiency of RANKL or RANK causes a form of what?

A

Osteopetrosis

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9
Q

Inherited deficiency of OPG causes increased bone resorption and what?

A

Osteoporosis

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10
Q

Osteoclasts are responsible for what process?

A

Bone resorption

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11
Q

Osteoblasts are responsible for what process?

A

Bone formation

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12
Q

What is the most numerous bone cell type?

A

Osteocytes

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13
Q

What is the function of sclerostin?

A

It is a protein that inhibits bone formation

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14
Q

Which three hormones mainly mediate calcium and phosphate homeostasis?

A

parathyroid hormone (PTH), vitamin D, and FGF-23

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15
Q

Vitamin D refers to which two compounds?

A

Cholecalciferol (D3) and ergocalciferol (D2)

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16
Q

True or false: Vitamin D3 is produced endogenously in the parathyroid gland

A

False. In the skin

17
Q

Why is Vitamin D considered a hormone?

A

It travels from the skin where it is produced in the blood to effect responses in distant target tissues

18
Q

Why or how is sunlight an important source of Vitamin D?

A

Vitamin D production in the skin is produced via exposure to sunlight

19
Q

Antiresorptive agents MOA

A

Antiresorptive agents prevent or arrest bone loss by suppressing osteoclastic bone resorption

20
Q

Hormone Replacement Therapy antiresorptive MOA

A

Estrogens reduce bone resorption by suppressing the transcription of genes coding for RANKL and cytokines such as IL-6

21
Q

Adverse effects of Hormone Replacement Therapy

A

Vaginal bleeding
Breast tenderness
Increased risk of venous thromboembolism
Increased long-term risk of breast cancer

22
Q

What are the different classes of antiresorptive agents?

A 
Hormone Replacement Therapy
Selective Estrogen Receptor Modulators
Bisphosphonates
RANKL Antagonists
Calcitonin
23
Q

What is the most commonly used class of antiresorptive drugs?

A

Bisphosphonates

24
Q

Bisphosphonates are analogues of pyrophosphates in which the readily _____ P-O-P bond is replaces by a ______ P-C-P bond

A

hydrolysable, nonhydrolyzable

25
Q

5 common examples of bisphosphonates

A 
Alendronate
Risedronate
Ibandronate
Pamidronate
Zoledronate
26
Q

What characteristic of bisphosphonates increases their antiresorptive activity?

A

Nitrogen-containing amino, pyridine, or imidazole moiety in the side chain

27
Q

Bone anabolic agents MOA

A

Increase bone mass and bone strength, not just prevent its loss

28
Q

What was the first bone anabolic agent?

A

Fluoride

29
Q

Fluoride MOA

A

Converts hydroxyapatite to fluoroapatite, which is denser and more brittle

30
Q

Native PTH contains how many amino acids?

A

84 AAs

31
Q

Is PTH an antiresorptive agent or a bone anabolic agent?

A

Bone anabolic agent

32
Q

What three classes of drugs are used to treat secondary hyperparathyroidism in CKD?

A

Oral phosphate binders
Calcitriol and its analogues
Calcimimetics

33
Q

What are the three active vitamin D congeners approved for treatment of secondary hyperparathyroidism?

A

Calcitriol- dihydroxylated form of vitamin D3
Paricalcitol- synthetic analogue of vitamin D
Doxercalciferol- 1α-hydroxylated form of vitamin D2

34
Q

Which was the first approved calcimimetic drug? What is its MOA?

A

Cinacalcet. Binds to the transmembrane region of the calcium-sensing receptor and thereby modulates receptor activity by increasing its sensitivity to calcium

Drug Action (17 decks)

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