Pharm: Osteoporosis Drugs Flashcards

1
Q

What is the MOA of calcitonin-salmon?

A

Inhibits the activity of osteoclasts to ↓ bone resorption

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2
Q

What are the 2 main clinical applications of calcitonin-salmon?

A
  • Tx of established osteoporosis
  • Used for Paget disease of bone
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3
Q

Bisphsphonates are structural analogs of what; what is their MOA?

A
  • Structural analogs of pyrophosphate, normal component of bone
  • Incorporated into bone, then inhibit bone resorption by ↓↓ both the number and activity of osteoclasts
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4
Q

Bisphosphonates are the drugs of first choice for what 5 conditions?

A
  • Postmenopausal osteoporosis
  • Osteoporosis in men
  • Glucocorticoid-induced osteoporosis
  • Paget disease of bone
  • Hypercalcemia of malignancy
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5
Q

What are the AE’s associated with bisphosphonates?

A
  • Esophagitis: minimized by taking meds with 8oz of water
  • Osteonecrosis of the jaw
  • Atypical femur fractures
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6
Q

Which bisphosphonate has been most commonly associated with osteonecrosis of the jaw and also dose-dependent kidney damage and rarely atrial fibrillation?

A

Zolendronic acid (IV)

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7
Q

Which SERM can be used to prevent and treat postmenopausal osteoporosis?

A

Raloxifene

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8
Q

Where is the SERM, Raloxifene an agonist and antagonist of estrogen effects?

A
  • Blocks in breast and uterus
  • Agonist in the bone
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9
Q

What is the drug of choice for prevention and treatment of postmenopausal osteoporosis in pt at risk of estrogen-dependent breast cancer?

A

Raloxifene

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10
Q

The SERM, Raloxifene increases the risk for what AE’s?

A
  • DVT’s
  • Pulmonary embolism
  • Stroke
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11
Q

What is the only drug for osteoporosis that increases bone formation?

A

Teriparatide

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12
Q

When Teriparatide is administered in which fashion it increases bone deposition by osteoblasts?

A

Given as a daily pulsed therapy

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13
Q

What is the MOA and effect of Denosumab?

A
  • Monoclonal antibody that is a RANKL inhibitor
  • Binds to RANKL and ↓ formation and function of osteoclasts –> ↓ bone resorption
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14
Q

What are the clincial uses of Denosumab; what should it be taken with?

A
  • Tx osteoporosis in postmenopausal women at high risk for fractures
  • Prevention of skeletal-related events in pt’s with bone metastases from solid tumors
  • Should be taken with calcium and vitamin D supplement to prevent hypocalcemia
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15
Q

What are some serious AE’s associated with Denosumab?

A
  • ↑ risk of new fractures
  • Osteonecrosis of the jaw
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16
Q

What is an important part of the therapy when treating osteoporosis in men; what are the 2 agents most commonly used?

A
  • Testosterone replacement is important part of therapy
  • Bisphosphonates (i.e., alendronate) = agent of choice
  • Denosumab is an alternative
17
Q

What is the MOA of cinacalet?

A
  • Binds to CaSR on parathyroid gland —> ↑ sensitivity to extracellular Ca2+
  • Leads to ↓ PTH secretion
18
Q

What are the clinical uses of Cinacalet?

A
  • Primary hyperparatyroidism (parathyroid carcinoma)
  • Secondary hyperparathyroidism due to CKD
19
Q

What are the 3 most common AE’s associated with Cinacalet?

A

Nausea + vomiting + diarrhea

20
Q

Which drugs can be used for non-inflammatory vs. inflammatory OA?

A
  • Acetaminophen for non-inflammatory OA
  • NSAIDs if inflammatory OA or acetaminophen is inadequate for pain in non-inflammtory OA
21
Q

List the dietary supplements commonly used for OA despite a lack of evidence of any meaningful benefit.

A
  • Glucosamine
  • Chondroitin
  • DMSO
  • SAMe
22
Q

Which topical NSAID is widely used for OA pain relief?

A

1% Diclofenec gel

23
Q

What are 4 effective oral antibiotics used for osteomyelitis; how long should tx be administered for?

A
  • Clindamycin
  • Rifampin
  • TMP-SMX
  • Fluoroquinolones
  • Consists of 4-6 week course… time needed for bone revascularization after debridement