Osteoporosis

Question 0

Teriparatide

Answer 0

Forteo- Osteoporosis, hypoparathyroidism
Recombinant PTH (stim remodeling, resorption, new bone formation)
Intermittent admin: bone growth (favors osteoblasts>clasts). Use for 18-24mo then antiresorption drugs, stops working.
CI: osteosarcoma

Question 1

Calcitonin

Answer 1

Miacalcin - Osteoporosis tx (not 1st line), Paget’s disease
Dec bone resorption of Ca, antagonizes PTH
Nasal spray or injection
Adverse: rhinitis/sinusitis-spray, N/V-injection

Question 2

Denosumab

Answer 2

Prolia- Ab vs receptor activator of nuclear factor RANKL
Tx for osteoporosis in postmeno females & high risk men. Inc bone mass& strenght in cortical and trabecular
Adverse: hypocalcemia, Osteonecrosis of the jaw (in Ca pts)
CI: hypocalcemia (absolute), risk of infection, preg/lact

Question 3

Alendronate

Answer 3

Fosamax- Biphosphonate (pyrophosphate analog): incorporates in bone, inhibits resorption. DOC postmeno osteoporosis

Question 4

Risedronate

Answer 4

Actonel- Biphosphonate (pyrophosphate analog): incorporates in bone, inhibits resorption. DOC postmeno osteoporosis

Question 5

Ibandronate

Answer 5

Boniva- Biphosphonate (pyrophosphate analog): incorporates in bone, inhibits resorption. DOC postmeno osteoporosis

Question 6

Zoledronic Acid

Answer 6

Zometa- Biphosphonate (pyrophosphate analog): incorporates in bone, inhibits resorption. DOC postmeno osteoporosis

Question 7

Etidronate

Answer 7

Didronel - Off label use

Biphosphonate (pyrophosphate analog): incorporates in bone, inhibits resorption

Question 8

Pamidronate

Answer 8

Aredia- off label use

Biphosphonate (pyrophosphate analog): incorporates in bone, inhibits resorption