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PHARM 3 > Bone mineral homeostasis > Flashcards

Bone mineral homeostasis Flashcards

(60 cards)

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1
Q

Magnesium levels effect on PTH secretion

A

moderate decrease in MG = inc in PTH

SEVERE decline in Mg = drop in PTH secretion

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2
Q

common causes of hypomagnesia

A

diarrhea
diuretics
alcohol abuse
chronic PPI and aminoglycoside use

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3
Q

PTH on intestine effect

A

indirect increase on calcium and phosphate absorption = via increase of vitamin D metabolite

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4
Q

PTH on kidney

A

decreased calcium excretion

increased phosphate excretion

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5
Q

Vit D on kidney

A

increased reabsorption of calcium and phosphate

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6
Q

net effect of PTH

A

increased serum calcium

decreased serum phosphate

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7
Q

net effect of vitamin D

A

increased serum calcium and phosphate

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8
Q

fibroblast growth factor 23

A

made by osteoblasts and osteoclasts = inhibits calcitrol production

dec calcium and phosphate reabsorption in kidney

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9
Q

Teriparatide

A

PTH analog

causes net increase in bone formation/mineralization

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10
Q

teriparatide use

A

osteoporosis

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11
Q

teriparatide kinetics

A

low intermit levels = anabolic effects

chronic admin = can cause primary hyperparathyroidism – catabolic effects –> osteitis fibrosa cystica

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12
Q

teriparatide AE

A

hypercalcemia - hypercalciuria

osteosarcoma

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13
Q

cholecalciferol

A

vit D analog

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14
Q

ergocalciferol

A

vit D analog

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15
Q

cholecalciferol/ergocalciferol use

A

added to calcium supplements and dairy products

regulates gene transcription via vitamin D receptor

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16
Q

cholecalciferol/ergocalciferol use

A

vit D deficiency
Rickets
osteomalacia

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17
Q

Vit D deficient type I

A

defective 1alpha hydroxylase enzyme

dec calcitriol = dec calcium, dec PO4

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18
Q

Vit D deficient type II

A

defective receptor

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19
Q

cholecalciferol/ergocalciferol AE

A

hypercalcemia, hyperphosphatemia, hypercalciuria

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20
Q

calcitriol

A

1,23-dihydroxyvitamin D3

  • management of secondary hyperparathyroidism
  • chronic kidney dz
  • management of hypocalcemia in pt with hypoparathyroidism
    (active form - doesn’t require metabolism)
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21
Q

doxercalciferol

A

1alpha-hydroxyvitamin D2

  • management of secondary hyperparathyroidism in pt with chronic kidney disease
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22
Q

19-nor-1,25-dihydroxyvitamin D2

A

paricalcitol

-calcitrol analog used for management of secondary hyperparathyroidism in pt with chronic kidney disease

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23
Q

calcipotriene

A

calcipotriol

used for topical tx of psoriasis

calcitriol analog

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24
Q

calcitonin

A

peptide hormone - inhibtis bone resportion

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25
calcitonin use
Paget disease | osteoporosis
26
calcitonin kinetics
salmon calcitonin = nasal spray or parenteral
27
calcitonin AE
rhinitis with nasal spray
28
alendronate
bisphosphonate suppresses osteoclasts and inhibits bone resorption - inhibits osteoclastic activity via dec farnesyl pryophosphate synthesis via disruption of mevalonate pathway decreases osteoclast H+ ATPase
29
alendronate use
osteoporosis | paget's disease
30
alendronate AE
esophageal irrigiation = reduced by drinking ater and remaining upright osteonecrosis of jaw adynamic bone
31
risedronate
bisphosphonate
32
ibandronate
bisphosphonate
33
pamidronate
bisphosphonate
34
zoledronate
bisphosphonate
35
ethinyl estradiol
activate estrogen receptors - changes in transcription of estrogen regulated genes
36
ethinyl estradiol use
prevent osteoporosis HRT OCP
37
ethinyl estradiol AE
moderate tox - breakthrough bleeding serious tox - thromboembolism, gall bladder dz, hyperTG, migraine, HA, HTN, depression postmenopausal women - breast CA, endometrial hyperplasia if in combo with P450 inducer -- breakthrough bleeding, dec contraceptive efficacy
38
raloxifene
SERM = estrogen agonist in bone, antag in breast and endometrium
39
raloxifene use
osteoporosis in postmenopasual women
40
raloxifene AE
hot flush | thromboembolism
41
Denosumab
RANKL inhibitor
42
denosumab MOA
bind RANK-L - prevents osteoclast differentiation
43
denosumab use
osteoporosis
44
denosumab AE
inc risk of infections
45
cinacalcet
calcimimetic stimulates calcium sensing receptor = decreaes PTH release/suppression
46
cinacalcet use
hyperparathyroidism - primary and secondary
47
cinacalcet AE
nausea, hypocalcemia, adynamic bone
48
calcium preps
calcium carbonate calcium citrate calcium lactate
49
calcium prep use
hypocalcemic tetany magnesium sulfate overdose used in eclampsia
50
calcium prep AE
necrosis and abscess formation thrombophlebitis
51
prednisone AE
glucocorticoid **note that the duration is longer than the half life AE: OSTEOPOROSIS, adrenal suppression, muscle wasting, salt retention
52
fluoride
chronic exposure -- dense but brittle bone
53
gallium nitrate
inhibits bone resorption | nephrotoxic
54
plicamycin
(mithracin) used in cancer related hypercalcemia
55
plicamycin AE
thrombocytopenia | hepatic/renal insufficiency
56
drugs causing osteoporosis
``` corticosteroids heparin lithium anastrozole alcohol ```
57
drugs causing osteomalacia
phenytoin | etidronate
58
sevelamer
phosphate binding drug - prevents absorption in GI tx for hyperphosphatemia
59
osteoporosis tx method
stop smoking, alcohol abuse, corticosteroid use perimenopausal women == HRT calcium Vit D supplement bisphosphonates SERMs teriparatide
60
thiazides
decreases excretion of calcium - increased reabsorption prevents renal stone formation tx HTN in osteoporosis pt

PHARM 3 (21 decks)

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