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PHARM > Osteoporosis and Gout Drugs > Flashcards

Osteoporosis and Gout Drugs Flashcards

1
Q

Alendronate

A

Bisphosphonate

Pyrophosphate analog => inhibits osteoclast

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2
Q

Alendronate treats

A

osteoporosis in post-menopausal, male, glucocorticoid-induced, Paget, malignancy hypercalcemia

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3
Q

Alendronate form

A

IV

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4
Q

Alendronate side effect

A

Esophagitis, osteonecrosis of jaw, atypical femur fractures, afib

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5
Q

Raloxifene

“Ralax that estrogen”

A

SERM

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6
Q

Raloxifene MOA

A

Estrogen blocked in breast and uterus, activating bones to prevent/treat post-menopausal osteoporosis

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7
Q

Raloxifene side effects

A

DVT, PE, stroke, pregnancy risk X, hot flashes

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8
Q

Raloxifene form

A

Oral, excreted in poop

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9
Q

Denosumab

“The den is RANK”

A

RANKL inhibitor

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10
Q

Denosumab MOA

“Dense those bones”

A

Increases bone density and strength; decreases formation of osteoclasts

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11
Q

Denosumab treats

A

post-menopausal women w/ high fracture risk and prevents skeletal events w/ bone metastases

Need to take Ca2+ and vitamin D to prevent hypocalcemia

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12
Q

Denosumab forms

A

Inject every 6 months SubQ

Bone mets req. 120 mg injected subQ every 4 weeks

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13
Q

Denosumab side effect

A

Jaw osteonecrosis, MSK pain, hypercholestermia, UTI

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14
Q

Teriparatide

A

PTH

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15
Q

Teriparatide MOA

A

Truncated version of endogenous 1-84 PTH made by recombinant DNA retaining full activity of PTH

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16
Q

Teriparatide is special because

“Terry builds bones”

A

this is only drug for osteoporosis that increases bone formation

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17
Q

Teriparatide administration

A

Pulsed therapy

NOT continuous

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18
Q

Zolendronic acid

“Zoe is a bish”

A

Bisphosphonate, IV once per year

Avoids GI issues, associated with osteonecrosis of jaw, dose-dependent kidney damage

19
Q

Treatment of osteoporosis in men

A
  1. Bisphosphonates
  2. Denosumab

Need testosterone replacement

20
Q

Drugs for hypercalcemia

A
  1. Furosemide
  2. Glucocorticoids
  3. Gallium nitrate (nephrotoxic)
  4. Bisphosphonates
  5. Inorganic phosphates (IV)
  6. Edetate disodium (Ca2+ chelator)
21
Q

Cinacalcet

A

Calcimimetic drug

22
Q

Cinacalcet MOA

A

binds CaSR to increase sensitivity to extracellular Ca2+, decreases PTH

23
Q

Cinacalcet treats

A

primary hyperparathyroidism, secondary hyperparathyroidism due to CKD

24
Q

How to manage osteoarthritis

A

NSAIDs

25
Q

Osteomyelitis treatment

A

Clindamycin, rifampin, TMP-SMX, fluoroquinolone

26
Q

Gout treatment

A

NSAIDs: naproxen, indomethacin, celexocib

Effective if initiated <48 hours

27
Q

Gout glucocorticoid treatment

A

Betamethasone, methylprednisone, triamcinolone

28
Q

Colchicine

“Cold stop the traffic”

A

Microtubule formation disrupter

diffuses into cells to bind tubulin and block microtubule formation => stops migration

29
Q

Colchicine treats gout for patients who are intolerant to

A

NSAIDs

30
Q

Colchicine warning

A

Do not give to renal, hepatic, GI pts

31
Q

Febuxostat

A

Xanathine oxidase inhibitor

32
Q

Xanathine oxidase inhibitor treats

A

recurrent gout, cancer chemo induced hyperuricemia

33
Q

Side effects of XO inhibitors

A

SJS

increased risk for HLA-B*5801 positive pts like chinese/thai

34
Q

Febuxostat is used for

A

pts who cannot tolerate Allopurinol

non-competitive inhibitor of xanthine oxidase

35
Q

Pegloticase and rasburicase

A

Recombinant uricase

36
Q

Pegloticase and rasburicase MOA

A

recombinant mammalian uricase - attached to methoxypolyethylene glycol

converts uric acid to far more soluble allantoin

treats chronic gout

37
Q

Rasburicase special because

A

Non-pegylated recombinant uricase that prevents acute uric acid nephropathy due to tumor lysis syndrome in patients w/ high risk lymphoma or leukemia

38
Q

Recombinant uricase forms

A

IV every 2 weeks

39
Q

Probenecid and sulfinpyrazone

A

uricosurics

40
Q

Probenecid

“I am pro-bending the kidney”

A

organic acid blocking urate reabsorption in renal tubule

41
Q

What increases urate reabsorption for probenacid?

A

Low dose ASA

42
Q

Probenecid MOA

A

increases urate fractional excretion

Treats underexcretion of urate w/ GFR > 60 mL/min

No stones to decrease pool of urate

43
Q

Probenecid treats

A

Hyperurecemia and tophi attacks

44
Q

Probenecid side effects

A

gouty arthritis flare, kidney stones, sulfa drug

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