Osteoporosis Flashcards
What does every single person with osteoporosis get treated with?
Calcium and Vitamin D
If someone only has a little bit of osteoporosis, can we just give them calcium and vitamin D and call it a day?
NO, they will not do the job alone. Need to start bisphosphonate at least
How does PTH increase calcium in a normal physiological way?
It stimulates osteoclast activity by acting on RANK ligand
How does estrogen maintain bone?
It just does
Can calicium and vitamin D alone treat OR prevent osteoporosis ?
No
What is the MOA of Calcitonin (Miacalcin)
Antagonizes PTH to decrease bone resorption of calcium
Why the FUCK would we use drugs that mimic PTH to treat osteoporosis?
When given intermittently* it will stimulate osteoblasts and the formation of new bone
What drugs are Parathyroid Hormone-like drugs that we use to treat osteoporosis?
Teriparatide (Forteo)
Abaloparatide (TYMLOS)
What are the adverse effects of Teriparatide and Abaloparatide?
Hypercalcemia
Hypercalciuria
What is the black box warning for teriparatide and abaloparatide?
May cause osteosarcoma
What is the MOA of Denosumab (Prolia)?
It is an antibody to RANK-Ligand, the factor made by osteoblasts that is necessary for the formation of mature osteoclasts
Where did the name Denosumab come from?
DEN- DENsity
OS- OSteo
U- hUman
MAB- Monoclonal AntiBody
(Thought this might help :)
Who should get Denosumab (Prolia)?
People at high risk for fractures, like CANCER PATIENTS
**
What is a side effect of Denosumab (Prolia)?
Osteonecrosis of the jaw
What is the first line #1 treatment for osteoporosis
Bisphosphonates
Are Zolendronate and Zolendronic acid the same thing?
Yes
What drugs are Bisphosponates?
Alendronate- oral
Risedronate- oral
Ibandronate- oral and IV
Zolendronate- IV
Etidronate- oral and IV
Pamidronate- IV
What is the MOA of Bisphosponates?
They incorporate INTO bone by replacing Phosphate
Inhibits osteoclast activity and bone resorption
Absorption of bisphosphonates is (great/terrible)
Terrible
How do you need to tell your patient to take oral bisphosphonates?
Empty stomach
Half glass of water
Stay upright after taking it to decrease esophageal irritation
What are the adverse effects of bisphosphonates?
TERRIBLE GI problems (upper GI irritation, esopageal ulcers, poop, etc)
OSTEONECROSIS OF THE JAW after major dental work
You are chit chatting with your old lady patient and she mentions she is getting some major dental work done next month. What drug do you need to make sure she stops taking?
Bisphosphonates****
Will cause necrosis oof the jaw
