B6.048 Drugs Affecting Bone Mineral Homeostasis

Question 1

calcium carbonate

Answer 1

cheap
cause gas, bloating, and constipation
neutralizes gastric acid and can cause rebound acid secretion
more concentrated, so smaller pills
TAKE W FOOD

Question 2

calcium citrate

Answer 2

fewer GI problems
pills do not affect gastric pH
can take without food

Question 3

calcium gluconate

Answer 3

IV only
for severe hypocalcemia
rapid infusion can cause arrhythmias

Question 4

vitamin D3

Answer 4

cholecalciferol
OTC
longest half life
requires bioactivation

Question 5

vitamin D2

Answer 5

ergocalciferol
Rx
requires activation
made by plants > vegetarian, but considered less physiological
low affinity, shorter half life
large dose 1-2x/week

Question 6

1,25 D3

Answer 6

calcitriol
most active
used for metabolic rickets and hypoparathyroidism
Rx

Question 7

side effects of denosumab

Answer 7

immunosuppressive

UTI, cataracts, obstipation, rashes, joint pain

Question 8

why aren’t estrogens recommended for treatment of osteoporosis

Answer 8

effects on breast, uterus, and CV systems

Question 9

cinacalcet

Answer 9

activates the CaSR in the parathyroid

used for 2ndary HPTH in renal disease and parathyroid carcinoma

Question 10

fluoride

Answer 10

stabilized hydroxyapatite crystals in bone and teeth
used to prevent dental caries
experimental treatment
toxicity @ 3-5 mg/kg (GI pain, nausea, vom, headache, 5-10 g lethal)

Question 11

thiazide diuretics

Answer 11

increase renal Ca2+ resorption at distal tubule
can augment effects of PTH
used for hypercalciuria