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Junior Pharm II > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

When is teriparatide CI?

A

Increased Ca2+ in urine or blood

Osteosarcoma

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2
Q

What is Denosumab NOT intended for

A

OP PVT

or in premeno women

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3
Q

Risedronate

A 
PO Bisphosphonates
PVT/TXT of OP postmeno
Increase BMD in men
TXT GCS induced OP
Pagets Disease
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4
Q

What are adverse effects of bisphosphonates?

A

GI issues (do not lie down for 30-60m)
Osteonecrosis of the jaw
Esophagitis/Cancer
Atypical fractures

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5
Q

MC SEs to denosumab

A

Msk pain
Hypercholestrolemia
Cystitis

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6
Q

What the CI of bisphosphonates?

A

CrCl <30ml/min
Hypocalcemia
Esophageal D/Os

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7
Q

If someone stops taking ERT will they still have the protective bone benefits?

A

NO

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8
Q

Raloxifene

A

SERM - Estrogen ag/antag depending on tissue

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9
Q

Calcitonin Salmon

A

PTH antagonist inhibiting OC esp at vertebrae (analgesic) and femur causes decreases Ca2+

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10
Q

Which chemical promotes OC activity

A

Calcitrol

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11
Q

What routes are available for calcitonin?

A

(IN)(SQ)(IM)

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12
Q

Raloxifene DIs

A

Bile acid resins
Warfarin
Thyroid hormones

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13
Q

Calcitonin has what type of serious adverse effects?

A

Increased cancer rates

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14
Q

Which bisphonates come in an PO formulation?

A

Alendronate (Daily/Wkly dosing PVT/TXT)
Risedronate (Daily/Wkly/Monthly dosing)
Ibandronate (PO) - (Monthly dosing)

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15
Q

What are the CI for ERT?

A

Hx of VTE
Breast/endometiral cancer
unDX genital bleeding

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16
Q

Conjugated Estrogen/Bazedoxifene

A

SERM

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17
Q

What is 2nd line OP drug for GCS induced OP after bisphosphonate?

A

Teriparatide

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18
Q

Which bisphosphonate only reduces vertebral fractures?

A

Ibandronate

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19
Q

What two drugs are reserved for high risk fractures past bisophosphantes?

A

Denosumab and Teriparatide

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20
Q

Which bisphosphonate is indicated for metastatic bone disease

A

Zoledronic acid

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21
Q

What lifestyle mods can someone with OP make?

A

Supplementation
Weight bearing exercise
No smoking/limit ETOH
Avoid excess GCS

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22
Q

What should someone take with a bisphosphonate?

A

A 8oz glass of water

23
Q

MOA - intermittent admin of human PTH analog stimulates bone formation

A

Teriparatide (SQ)

24
Q

Ibandronate

A

(PO/IV) Bisphosphonates
PVT/TXT OP
Only reduces vertebral fxs

25
Q

MOA- selectively binds to anti-resoprtive surfaces incorporating into bone

A

Bisphosphonates (Decreased OC activity)

26
Q

What are 2 SERM drugs for OP

A

Raloxifene / Bazedoxifene/Conjugated Estg

27
Q

Serious SE’s to denosumab

A

Hypocalcemia
Jaw necrosis
Infection due to supresses immune sys
Dermtological issues

28
Q

Teriparatide

A

(SQ) PTH analog (1-34aa)

29
Q

How long is bisphosphonates T1/2?

A

Up to 10 year half life

30
Q

Which bisphonates come in an IV formulation?

A 
Ibandronate (3 month dosing - postmeno)
Zoledronic acid (yearly dose)
31
Q

What are the indicated uses for Raloxifene?

A

PVT/TXT OP in
postmeno w/ high risk of breast cancer
postmeno who cant take bisphosphonates
or concerned about bisphosphonate safety

32
Q

Raloxifene CIs

A

Hx of VTE
If hip fracture is primary concern
Premeno women/pregnancy (teratogen)

33
Q

What should be corrected before initiating bisphosphonate therapy?

A

Vit-d and mineral deficits 1st

34
Q

Which is Calcitonin route is better for common side effects?

A 
IN - less nausea/flushing
Calcitonin Salmon (miacalcin)
35
Q

MOA - Monoclonal AB binds to RANK ligand inhibiting OC

A

Denosumab (SQ)

36
Q

How long should bisphosphonate TXT last at least?

A

5 years

37
Q

What is the primary actions of Calcitonin?

A

Vertebral and femoral sites

38
Q

Denosumab

A

Monoclonal antibody antibody binds RANK ligand inhibiting OC activity

39
Q

What is naturally secreted by the thyroid?

A

Calcitonin

40
Q

What are teriparatide use indications

A

High risk fractures
CI bisphosphonates
GCS induced OP

41
Q

Which bisphosphonate is not indicated for pagets disease?

A

Ibandronate

42
Q

Which OP drug is indicated for androgen depravation?

A

Denosumab

43
Q

What is 1st line in most OP pts?

A

Bisphosphonates

44
Q

Zoledronic acid

A 
(IV) Bisphosphonates (Metastatic bone DZ)
PVT/TXT of OP postmeno
Increase BMD in men
TXT GCS induced OP
Pagets Disease
45
Q

When is Denosumab ok for initial therapy?

A

Pt is at high risk of fracture
and
Bisphosphonates are CI (renal dysfx/PO)

46
Q

What is the maximum timeframe to use teriparatide?

A

2 years max (cancer risk)

47
Q

Which drug may have an analgesic effect with vertebral fractures?

A

Calcitonin

48
Q

What are the FDA indications for calcionin?

A

TXT of OP >5yr postmeno
Hypercalcemia
Pagets disease

49
Q

What dosing should be considered for Estrogen replacement therapy in a postmenopausal woman?

A

Lowest dose possible-lowers vasomotor S/S

50
Q

How long should someone wait before taking meds, food, drink after taking bisphosphonate?

A

30m

Ibandronate - 60m

51
Q

Recommended dietary supplements for OP

A

Calcium - 1200mg/D

Vit-D 800IU/D

52
Q

Which OP drugs promote OB activity

A

Teriparatides

53
Q

Alendronate

A 
(PO) Bisphosphonates
PVT/TXT of OP postmeno
Increase BMD in men
TXT GCS induced OP
Pagets Disease
54
Q

MOA - Inhibits OC by antag PTH

A

Calcitonin

Junior Pharm II (8 decks)

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