Parathyroid & Calcium Homeostasis

Question 1

Parathyroid Hormone

Answer 1

Teriparatide
- rPTH
USE: Intermittent Administration for Steroid Induced Osteoporosis
MOA: INC osteoclast production via RANKL stimulation

Question 2

RANKL

Answer 2

Receptor
Activator of
Nuclear factor
Kappa-Beta
Ligand
**INC both number and activity of Osteoclasts

Question 3

Calcitonin

Answer 3

- Made by Thyroid
MOA:
- DEC in Ca and PO4 reabsorption in gut
- DEC in Bone Resorption
USE: Hypercalcemia, Osteoporosis, Paget Disease of Bone

Question 4

Vitamin D

Answer 4

D3 - Cholecalciferol
D2 - Calciferol
- Processed by liver into CALCITRIOL
MOA: INC Ca and PO4
USE: Ricketts (Vit D Resistant and Dependent), Renal Ricketts , Hypoparathyroidism

Question 5

Bisphosphonates

Answer 5

"Dronate Drugs"
Pamidronate
Etidronate
Alendronate
Risendronate
Zolendronate - (SE: Osteonecrosis of Jaw)
MOA:
- Block Osteoclast Activity
- INC Osteoclast Apop
- Block Farnesyl prophosphate
- Dissolution of Hydroxyapatite crystals
USE: Osteoporosis, Paget Disease, Hypercalcemia malignancy, Osteoclastic Bone Metastasis
SE: DEC Renal Fxn, Dysphagia, PUD

Question 6

Denusomab

Answer 6

MOA: Inhibits RANKL
- DEC in osteoclasts
USE: Osteoporosis, Giant Cell Tumor of Bone

Question 7

Cincalcet

Answer 7

MOA: Calcimimetic (INC Ca receptor sensitivity on PT)
- Blocks PTH Secretion
USE: Secondary Hyperparathyroidism in CRD, Parathyroid Carcinoma

Question 8

Hypercalcemia Drugs

Answer 8

Pilacamycin (MOA: DEC Bone Resorption)

Gallium Nitrate