B6-048 Drugs: Bone Mineral Homeostasis

Question 1

oral glucocorticoids are a major risk factor for

Answer 1

osteoporosis

Question 2

calcium and phosphorus regulation is regulated by [2 main ones she mentioned]

Answer 2

1,25-dihydroxvitamin D3
Parathyroid hormone

Question 3

PTH and vitamin D stimulate […] proliferation and differentiation

Answer 3

preosteoblast

Question 4

PTH and vitamin D stimulate differentiation and activation of […]

Answer 4

osteoclasts

Question 5

used as prophylaxis treatment of osteoporosis

Answer 5

calcium

Question 6

used to treat hypocalcemia due to dietary insufficiency or malabsorption states

Answer 6

calcium

Question 7

oral preparations of calcium [2]

Answer 7

calcium carbonate
calcium citrate

Question 8

IV preparation of calcium

Answer 8

calcium gluconate

Question 9

most likely calcium supplement to cause gas, bloating, and constipation

Answer 9

calcium carbonate

Question 10

which calcium MUST be taken with food

Answer 10

calcium carbonate

Question 11

oral calcium that is cheapest

Answer 11

calcium carbonate

Question 12

oral calcium that causes fewer GI problems and can be taken without food

Answer 12

calcium citrate

Question 13

used to treat osteoporosis and osteomalacia in combination with calcium

Answer 13

vitamin D

Question 14

prophylaxis and treatment of nutritional rickets

Answer 14

vitamin D

Question 15

which vitamin D has the longest half life?

Answer 15

cholecalciferol (D3)

Question 16

which vitamin D requires bioactivation?

Answer 16

cholecalciferol (D3)

Question 17

most active form of vitamin D
requires prescription

Answer 17

calcitriol

Question 18

vitamin D used for metabolic rickets, hypothyroidism, secondary HyperPTH due to kidney failure

Answer 18

calcitriol

Question 19

vegetarian option for vitamin D, but is less physiological overall

Answer 19

ergocalciferol

Question 20

which form of vitamin D is OTC?

Answer 20

cholecalciferol

Question 21

suppress the activity of osteoclasts inhibits bone resorption

Answer 21

bisphosphonates

Question 22

bisphosphonates are primarily used to treat

Answer 22

osteoporosis

Question 23

instructions for taking bisphosphonates

Answer 23

take with full glass of water on an empty stomach and remain upright for 30 min

Question 24

most common adverse effect of bisphosphonates

Answer 24

esophageal and gastric irritation

Question 25

long term use (5+ years) of bisphosphonates can cause

Answer 25

osteonecrosis of the jaw

Question 26

a "drug holiday" from bisphosphonates is recommended after [...] years

Answer 26

3-5

Question 27

etidronate is administed [time]

Answer 27

daily

Question 28

alendronate is administered [time]

Answer 28

weekly

Question 29

risendronate is administered [time]

Answer 29

monthly

Question 30

IV bisphophonate administered annually

Answer 30

zoledronic acid

Question 31

bisphosphate that is available in oral and IV preparations

Answer 31

ibandronate **monthly or quarterly

Question 32

etidronate is only used to treat

Answer 32

Paget's

Question 33

stimulates new bone that is structurally normal, structurally analogous to PTH

Answer 33

teriparatide

Question 34

not recommended for use > 2 years d/t black box warning for osteosarcoma

Answer 34

teriparatide

Question 35

how is teriparatide administered?

Answer 35

sub q

Question 36

works to increase bone mass, but is not as effect as bisphosphonates or teriparatide

Answer 36

calcitonin

Question 37

RANKL inhibitor that suppresses bone resorption

Answer 37

denosumab

Question 38

sclerostin inhibitor suppresses bone resorption and increases bone formation

Answer 38

romosozumab

Question 39

should be administered with calcium and vitamin D

Answer 39

romosozumab

Question 40

acts as an agonists in bone and liver antagonist in breast and uterus

Answer 40

raloxifene

Question 41

SERM

Answer 41

raloxifene

Question 42

reduces bone-resorbing effects of PTH but not recommended for postmenopausal osteoporosis

Answer 42

estrogen **increased risk of cancer

Question 43

activates the calcium sensing receptor (CaSR) in parathyroid gland

Answer 43

cinacalcet

Question 44

used to treat secondary hyperparathyroidism in renal disease and parathyroid carcinoma

Answer 44

cinacalcet

Question 45

stabilizes hydroxyapatite crystal in bone and teeth used to prevent dental caries

Answer 45

fluoride

Question 46

increase Ca+ reabsorption in the DCT used to treat hypercalciuria

Answer 46

thiazide diuretic

Question 47

decrease Ca++ absorption increase Ca++ excretion block bone formation

Answer 47

glucocorticoids **lead to osteporosis

Question 48

recombinant PTH analog

Answer 48

teriparatide

Question 49

osteonecrosis of the jaw is an adverse effect of

Answer 49

bisphosphonates

Question 50

slow the formation and dissolution of hydroxyapatite crystals

Answer 50

bisphosphonates

Question 51

bisphosphonate that is administered once yearly

Answer 51

zoledronic acid

Question 52

calcimimetic

Answer 52

cinacalcet

Question 53

treatment for hypocalcemic tetany

Answer 53

calcium gluconate

Question 54

thiazide diuretics increase [...] at the distal tubule

Answer 54

calcium resorption

Question 55

activates CaSR and is used to treat secondary hyperparathyroidism

Answer 55

cinacalcet

Question 56

RANKL inhibitor used to treat osteoporosis

Answer 56

denosumab

Question 57

how do glucocorticoids (prednisone) cause osteoporosis?

Answer 57

decreases Ca++ absorption increases Ca++ excretion blocks bone formations

Question 58

[...] are sometimes used in hypogonadal men with low bone density

Answer 58

androgens