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NMSP Exam 3 > [PHARM] Pharm of Osteoporosis and Gout [Wolff] > Flashcards

[PHARM] Pharm of Osteoporosis and Gout [Wolff] Flashcards

1
Q

What are calcium salts used to treat?

A

Mild hypocalcemia

Simply as dietary supplements

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2
Q

What symptoms can hypercalcemia cause?

A

GI disturbances (constipation)

CNS effects (lethargy)

Renal dysfunction (polyuria, kidney stones)

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3
Q

What is given to pts with severe hypocalcemia?

A

PARENTERAL calcium salts

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4
Q

What are the two compounds that we are referring to when talking about vitamin D?

A

Ergocalciferol

Cholecalciferol

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5
Q

What compound of vitamin D occurs in plants?

What compound of vitamin D is produced when exposed to sunlight?

A

Plants = ergocalciferol

Sunlight = cholecalciferol

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6
Q

Calcitonin-Salmon

MOA?

Effects?

Clinical applications?

A

Similar in fxn to human calcitonin, but has longer half life and greater potency

Inhibits osteoclasts; Decrease bone resorption

Established osteoporosis

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7
Q

What is the suffix for bisphonphonates?

A

-dronate

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8
Q

Name examples of bisphosphonate drugs

A

Alendronate

Risedronate

Ibandronate

Tiludronate

Zolendronic acid

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9
Q

Alendronate

MOA

Effects

Clinical applications

Toxicities

A

Structural analog of pyrophosphate; normal constituent of bone

Incorporates into bone, then inhibits bone resorption by decreasing activity of osteoclasts; kills them

Osteoporosis, Paget dz, Hypercalemia of malignancy

Esophagitis, Osteonecrosis of the jaw, atypical femur fractures

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10
Q

What is the one bisphosphonate drug that avoids GI problems?

A

Zolendronic acid

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11
Q

What is the one SERM drug that is useful in treating osteoporosis?

A

Raloxifene

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12
Q

Raloxifene

MOA

Effects

Clinical applications

Toxicities

A

SERM

Blocks estrogen in breast and uterus, but AGONIZES estrogen in bone

Postmenopausal osteoporosis

DVT, PE, Stroke

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13
Q

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

A

Teriparatide

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14
Q

What is teriparatide?

How does it work to form bone?

A

(1-34) Version of endogenous PTH

When given daily pulsed therapy, OSTEOBLAST activity predominates

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15
Q

What class is denosumab in?

A

RANKL inhibitor

*monoclonal antibody

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16
Q

Denosumab

Effects?

Clinical applications?

Toxicities?

A

By binding RANKL, it decreases formation and function of osteoclasts

Osteoporosis

Delays fracture healing, new fractures, osteonecrosis of the jaw

17
Q

What is an important consideration in the treatment of osteoporosis in men?

A

Testosterone replacement

18
Q

What is the one calcimimetic drug?

A

Cinacalcet

19
Q

Cinacalcet

Effects?

Clinical applications?

A

Binds to Ca2+ sensing receptors in PT gland, increases sensitivity to extracellular Ca2+ and decreases PTH secretion

Primary hyperparathyroidism, Secondary Hyperparathyroidism due to CKD

20
Q

What is osteomeylitis?

A

Bacteria induced break of the bone that won’t heal

The canaliculi and too small for white cells, large enough for bacteria

21
Q

What are some foods that have HIGH purine diet (not recommended for GOUT patients)?

A

Mussles

Meat extracts

Internal organs

Yeast

Fruits

Fish

Nuts

22
Q

What are examples of LOW purine containing foods?

A

Cheese

Eggs

Cereals

Bread

Butter

Milk

Coffee/tea

Vegetables

23
Q

Gout patients one either one of two categories to develop their disease…

They are uric acid…

A

Underexcreters

Overproducers

24
Q

Most gout patients are uric acid…

A

UNDEREXCRETERS

25
Q

What are the steps in the initial management of acute gout?

A

NSAIDs

Colchicline

Glucocorticoids

26
Q

What are the (3) primary NSAIDS indicated for gout?

A

Naproxen

Indomethacin

Celecoxib

27
Q

Colchicine

MOA?

Effects?

Clinical applications?

A

Blocks formation of microtubules

Inhibits leukocyte migration and phagocytosis

Pts with NSAID intolerance with gout

28
Q

Allopurinol

MOA

Effects

Toxicities

A

Competitive inhibitor of xanthine oxidase

Without conversion to urate, hypoxanthine and xanthine are excreted; both are more soluble than urate

Stevens-johnson

29
Q

Febuxostat

MOA

Effects

What priority

Downside

A

Inhibitor of xanthine oxidase

Without conversion to urate; hypoxanthine and xanthine are excreted

2nd line; if allopurinol isn’t tolerated

Expensive

30
Q

Pegloticase

MOA

Effects

Toxicities

A

Recombinant mammalian uricase

Converts uric acid to the far more soluble allantoin

Infusion reactions

31
Q

Probenecid

MOA

Effects

Clinical application

A

Organic acid that blocks urate resorption

Increases excretion of urate

Underexcreters with GFR >60ml/min and NO STONES

32
Q
A

NMSP Exam 3 (15 decks)

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