Bone Mineral Homeostasis

Question 1

concept: what does hypomagnesium do to PTH

Answer 1

decreases –> leads to hypocalcemia

Question 2

concept: what are common causes of hypomagnesium

Answer 2

chornic diarrhoea, diuretics, alcohol abuse, chronic PPI and aminoglycoside use

Question 3

MOA Teriparatide

Answer 3

recombinant PTH that stimulates bone formation if you give it PULSATILE
@ high does - resorption

Question 4

MOA Denosumab

Answer 4

RANK L inhibitior

prevents stimulation of osteoclast

Question 5

A/se Denosumab

Answer 5

increased infection risk

Question 6

Type I Vitamin D dependent Rickets

Answer 6

defective 1alpha hydroxylase

Question 7

Type II vitamin D dependent RIckets

Answer 7

defective receptor

Question 8

Treat Psoriasis

Answer 8

calcipotriol

Question 9

What is cholecalciferol

Answer 9

vitamin D3

Question 10

What is ergocalciferol

Answer 10

vitamin D2

Question 11

MOA Sevelamer

Answer 11

phosphate binding drug –> no absoprtion of dietary phosphate in teh Gi

Question 12

uses of Sevelamer

Answer 12

phosphate binding drug - used to prevent hyperphosphatemia in chronic renal dailure patients

Question 13

Treat overdose of magnesium sulfate in eclampsia please

Answer 13

calcium gluconate IV style

Question 14

A/se estrogen

Answer 14

thromboembolism
migraine
increased risk of breast and endometrial cancer

Question 15

What’s a SERM?

Answer 15

Selectie Estrogen Receptor Modulator

Question 16

Name some SERMs

Answer 16

Tamoxifen, Raloxifene

Question 17

Describe Tamoxifen

Answer 17

antag @ breat
agonistic @ bone
agonistic @ bone

Question 18

A/se tamoxifen

Answer 18

increasedk endometrial ca and thrmoboembolism and hot flushes

Question 19

Uses of tamoxifen

Answer 19

breast cancer and beneficial effect on bone

Question 20

Describe Raloxifene

Answer 20

antag at breast
agonist at bone
no estrogenic effect on endometrium

Question 21

Name the bisphosphnates

Answer 21

etriDRONATE
alenDRONATE
pamiDRONATE
riseDRONATE

Question 22

MOA of bisphosphonates

Answer 22

inhibit osteoclasitc activity via decreasing farnesyl pyrophosphate synthesis = disrupts mevlonate pahtway decreased osteoclast HATPase = reduced resorption

Question 23

Which bisphoshonate should not be used long term and why please

Answer 23

Etidronate - dont use it when its late –> bone malformation due to decreased osteoblastic activity

Question 24

What do you use etidronate, alendronate, pamidronate and risedronate for?

Answer 24

osteoporsis
malignancy associated with hypercalceim
Paget disease

Question 25

a/se of bisphosphates DRONATEs

Answer 25

erosive esophagitis

Question 26

a/se of etidronate

Answer 26

osteomalacia | osteonercorsis of jaw and fracures

Question 27

MOA cinacalcet

Answer 27

activates calcium sensing receptors --> leads to decreased PTH

Question 28

uses of cinacalcet

Answer 28

secondary hyperparathyroidism | parathyroid carcinoma

Question 29

Treat parathyroid carcinoma

Answer 29

cinacalcet - stimulates CaSR

Question 30

Flouride it up

Answer 30

chronic exposure - new bone synthesis that is denser but brittle

Question 31

describe gallium nitrate

Answer 31

inhibits bone resoprtion nephrotoxic used at cancer-related hypercalcemia

Question 32

Plicamycin/mithracin

Answer 32

cytotoxic acnticancer drug used at cancer-related hypercalceim (wiht gallim nitrate)

Question 33

cancer related hypercalcemia

Answer 33

plicamycin and gallium nitrate

Question 34

Name the drugs that cause osteoporsis

Answer 34

``` AACHL alcohol Anastrozole chorticosteroids heparin lithium ```

Question 35

name drugs that cause osteomalacia

Answer 35

phenytoin | etridronate if used for more than 12 months

Question 36

Treat the hypercalcemia

Answer 36

furosemide - diuretic biophosphonates (DRONATES) inhibit osteoclast activity calcitonin parathyroidectomy

Question 37

Treat osteoporosis

Answer 37

``` stop smoking stop OH abuse stop corticosteroids (otehr drugs that can cause - anastrozole, Li and heparin) calcium and vit B supplementation bisphosphonates DRONATES SERMs terparatide ```