Osteoporosis Pharmacology

Question 1

Anti-resoprtive therapy

Answer 1

Bisphosphonates
SERMs
Calcitonin

Question 2

Anabolic therapy

Answer 2

Teriparatide

Promote new bone formation

Question 3

Vitamin D

Answer 3

Needed in those with limited sun exposure

Maximize Ca reabsorption

Question 4

Dihydrotachysterol

Test question

Answer 4

Synthetic Vit D
Does NOT required renal hydroxylation!!!!
Rapid onsetm greater effects minieralization of bone salts

Question 5

Bishphosphates

Answer 5

PCP analogs of pyrophosphate
Alendronate
Risendronate
ANTIRESORPTIVES

Question 6

Bisphosphates First gen MOA

Answer 6

Increase clast cell death and decrease function

Question 7

Bisphosphate 2/3rd gen MOA

Answer 7

Interfere with isoprenoid lipid biosynthesis

Question 8

Nitrogen Containing Bisphosponates

Test question

Answer 8

Inhibit Farnesyl Diphosphate Synthase

Lead to inadequate prenylation which compromises clast function and apoptosis!!!!!

Question 9

Teriparatide

Answer 9

Recombinant version of human PTH
Activates blast (new bone formation and increased BMD)
Does NOT change calcium absorption
2 years MAX

Question 10

Calcitonin

Test question

Answer 10

Reduction in the ruffled border surface of osteoclast diminishing their resorption activity –> decrease resorption

Question 11

Salmon Clacitonin

Answer 11

Anti-resorptive

Question 12

RANKL

Answer 12

Osteoblast precursor

Question 13

RANK

Answer 13

Clast precursor

Question 14

RANKL and RANK signalling lead to?

Answer 14

Differentiation, activation and enhanced survival of clasts –> resorption

Question 15

Osteoprotegerin

Answer 15

Decoy receptor for the RANKL –> preventing binding to its RANK

Question 16

Denosumab

Answer 16

Pharmacologic agent that essence acts like osteoprotegerin as a decoy receptor for osteoblastic RANKL

Question 17

Denosumab uses

Answer 17

Severe osteoporosis

Inhibits resorption and suppresses bone turnover

Question 18

Androgens

Answer 18

Increase BMD
ADRs increased secondary sex characteristics
Prostate cancer!!

Question 19

Estrogen Pros

Answer 19

Strengthens bones

Lower LDL and higher HDL

Question 20

Estrogen Cons

Answer 20

Breast cancer risk
Uterine cancer risk
Blood clot risk

Question 21

SERM Reloxifene

Answer 21

Estrogen agonists in bone
Antagonists in breast
Antiresorptive

Question 22

Ca supplements can

Answer 22

decrease absorption of iron and drugs (TC and phenytoin)