Unit 5-Parathyroid and Bone Flashcards

1
Q

Alendronate

Drug class

A

Bisphosphonate

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2
Q

Alendronate

Mechanism

A

Reduce osteoclastic bone resorption

Oral formulation; patient must be sitting upright, fasting, for 30 minutes; takes several days to see effect

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3
Q

Alendronate

Uses

A

Hypercalcemia; osteoporosis; Paget’s disease of bone

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4
Q

Alendronate

Side effects

A

Esophageal irritation

Iritis, myalgias, AFF long-term possibly

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5
Q

Risedronate

Drug class

A

Bisphosphonate

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6
Q

Risedronate

Mechanism

A

Reduce osteoclastic bone resorption

Oral formulation; patient must be sitting upright, fasting, for 30 minutes; takes several days to see effect

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7
Q

Risedronate

Uses

A

Hypercalcemia; osteoporosis; Paget’s disease of bone; prevention of fractures in osteogenesis imperfecta

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8
Q

Risedronate

Side effects

A

Esophageal irritation

Iritis, myalgias, AFF long-term possibly

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9
Q

Ibandronate

Drug class

A

Bisphosphonates

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10
Q

Ibandronate

Mechanism

A

Reduce osteoclastic bone resorption

Oral and IV formulations; patient must be sitting upright, fasting, for 30 minutes; takes several days to see effect

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11
Q

Pamidronate

Drug class

A

Bisphosphonate

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12
Q

Pamidronate

Mechanism

A

Reduce osteoclastic bone resorption

Bypasses GI tract (given IV); takes several days to see effect for lowering calcium

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13
Q

Pamidronate

Uses

A

Hypercalcemia of malignancy; Paget’s disease of bone; prevention of fractures in osteogenesis imperfecta

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14
Q

Pamidronate

Side effects

A

Fever, flu-like symptoms

Iritis, myalgias, AFF long-term possibly

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15
Q

Zoledronic acid

Drug class

A

Bisphosphonate

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16
Q

Zoledronic acid

Mechanism

A

Reduce osteoclastic bone resorption

Bypasses GI tract (given IV); takes several days to see effect for lowering calcium

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17
Q

Zoledronic acid

Uses

A

Hypercalcemia of malignancy; Paget’s disease of bone; prevention of fractures in osteogenesis imperfecta

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18
Q

Zoledronic acid

Side effects

A

Fever, flu-like symptoms

Iritis, myalgias, AFF long-term possibly

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19
Q

Cinacelcet

Drug class

A

Calcimimetic

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20
Q

Cinacalcet

Mechanism

A

Reduces PTH and serum calcium levels

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21
Q

Cinacalcet

Uses

A

Secondary hyperparathyroidism from renal disease; parathyroid carcinoma; hypercalcemia in primary hyperparathyroidism not treatable by surgery

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22
Q

Cinacalcet

Side effects

A

Vision changes, palpitations, dizziness, chest pains, headache

23
Q

Calcitonin

Drug class

A

Amino acid peptide

24
Q

Calcitonin

Mechanism

A

Increases urinary calcium excretion, inhibits bone reabsorption (modest effect)

25
Q

Calcitonin

Uses

A

Short-term relief of hypercalcemia; Paget’s disease of bone

26
Q

Calcitonin

Side effects

A

Minimal (e.g., rhinitis)

No longer recommended for use in nasal spray form because of increased cancer risk. Can still use SQ or IM. Tachyphylaxis in 2-3 days; often used to bridge treatment for other medication

27
Q

Teriparatide

Drug class

A

PTH analog

28
Q

Teriparatide

Mechanism

A

Short bursts given SQ, stimulating bone resorption and bone formation via osteoblasts

29
Q

Teriparatide

Uses

A

Osteoporosis (high risk patients who have failed other treatments)

30
Q

Teriparatide

Side effects

A

Transient mild hypercalcemia

Requires daily SQ injections; contraindicated in those with increased chance of osteosarcoma (e.g., Paget’s disease of the bone, radiation exposure)

31
Q

Raloxifene

Drug class

A

Selective estrogen receptor modulator

32
Q

Raloxifene

Mechanism

A

Selectively activates certain estrogen receptors, but blocks others

33
Q

Raloxifene

Uses

A

Osteoporosis

34
Q

Raloxifene

Side effects

A

Increase risk of hot flashes, DVT

35
Q

Hydrocortisone; Prednisone

Drug class

A

Corticosteroids

36
Q

Hydrocortisone; Prednisone

Mechanism

A

Decreases production of 1,25 vitamin D; may inhibit growth of neoplastic lymphoid tissue

37
Q

Hydrocortisone; Prednisone
Uses

A

Hypercalcemia from vitamin D intoxication, granulomatous diseases

Hydrocortisone given IV, prednisone orally

38
Q

Calcium carbonate

Drug class

A

Phosphate binder

39
Q

Calcium carbonate

Mechanism

A

Binds phosphate

40
Q

Calcium carbonate

Uses

A

Secondary hyperparathyroidism from renal disease

41
Q

Calcium acetate

Drug class

A

Phosphate binder

42
Q

Calcium acetate

Mechanism

A

Binds phosphate

43
Q

Calcium acetate

Uses

A

Secondary hyperparathyroidism from renal disease

44
Q

Sevelamer

Drug class

A

Phosphate binder

45
Q

Sevelamer

Mechanism

A

Binds phosphate

46
Q

Sevelamer

Uses

A

Secondary hyperparathyroidism from renal disease

47
Q

Calcitriol; Paracalcitol (Zemplar); Doxercalciferol (Hectorol)

Drug class

A

vitamin D analog

48
Q

Calcitriol; Paracalcitol (Zemplar); Doxercalciferol (Hectorol)

Mechanism

A

Binds to VDR and elevates serum calcium levels

49
Q

Calcitriol; Paracalcitol (Zemplar); Doxercalciferol (Hectorol)

Uses

A

Secondary hyperparathyroidism from renal disease

Given orally daily or IV several times a week

50
Q

Denosumab

Drug class

A

Monoclonal antibody

51
Q

Denosumab

Mechanism

A

RANK ligand inhibitor (targets early effect of osteoclasts on bone)

Given SQ every 6 months; can be given at lower GFR levels

52
Q

Denosumab

Uses

A

Osteoporosis

53
Q

Denosumab

Side effects

A

Concern for rashes, myalgias; AFF possible