Parathyroid pharm Flashcards
Calcitonin
inhibits osteoclastic bone resorption
Vitamin D3
cholecalciderol
preffered in repletion
Vitmain D2
ergocalciferol less efficient than D3
comes from plants
25-OH-D3
calcifediol
storage form
useful in patients with liver disease
1,25-(OH)2 Vit D3
calcitriol
active form of D3
paracalcitol
calcitriol analog
used in secondary hyperparathyroidism
No hypercalcemia
effects of estrogen on bone
decrease number and activity of osteoclasts
increase osteoblast production of osteoprotegerin (OPG)
glucocorticoid actions on Bone
lowers Ca2+ serum (antagonizing Vit D in gut)
-increase PTH–>increase activity of the clasts
Increase production of RANK-L and decrease OPG–> OC activation
-increase bone resorption
Suppresses osteoblasts
Bisphosphonates
MOA
S/E
ending
(alendronate, risedronate, ibandronate, zoledronate)
most effective drug for tx and prevention of osteonecrosis
MOA- direct inhibit effects of osteoclasts
S/E- Esophagitis and GI irritation, osteonecrosis of the jaw
SERM
S/E
(raloxifene, bazedoxifene)
reduce risk of osteoporosis but less effective than estrogen or bisphosphonates
MOA-selective estrogen receptor agonists
s/e- worsening of menopausal vasomotor symptoms (HOT FLASHES)
- risk of VTE disorders
Teriparatide
MOA
S/E
used to TX severe osteoporosis
only agent for tx of osteoporosis that stimulates bone formation
S/E- usual N/V, HA, dizziness, muscle cramps
Denosumab
MOA- humanized monoclonal antiboday against RANKL
Tx of patients who are high risk for fracture
Salmon calcitonin
approved for Tx (not prevention) of osteoporosis
use declining
inhibition of osteoclastic bone resoption
nasal spray or SC
which diuretic increases calcium levels in serum
thiazide
How to Treat acute severe hypocalcemic tetany?
Calcium Gluconate- tx of choice IV
Calcium chloride- less desirable
* serum Mg2+ levels should be normalized if low
