Bone Mineralization part 2 Flashcards
How do Bisphosphonates increase bone density?
Bisphosphonates increase bone density by inhibiting bone resorption, and osteoclastic function by inducing osteoclast apoptosis
Bisphophonates all have what suffix?
-onate
all of the currently available bisphosphonates have this complication of? Except which one? ****
gastric irritation (except etidronate).
bisphosphonates are indicated for? (6)
- osteoporosis
- postmenopausal osteoporosis
- glucocorticoid-induced osteoporosis
- paget’s disease
- bone metastases
- cancer-induced hypercalcemia..
Which two Bisphosphonates can only be given IV
Pamidronate and Zoledronate
oral bisphosphonates are first line therapy for what?
primary and secondary prevention of fractures.
rare but serious ADE of bisphosphonates?****
osteonecrosis of the jaw.
Contraindications to the administration and use of bisphosphonates include? (3)
decreased renal function, esophageal motility disorder and peptic ulcers.
Denosumab MOA?
binds to RANKL which prevents RANKL from binding to RANK thus inhibits osteoclast formation and activity.
Indications for denosumab?
postmenopausal women or men with osteoporosis at high risk for fracture
Contraindications to denosumab includes ?
hypocalcemia.
Serious ADE of Denosumab
Osteonecrosis of the jaw has been reported with denosumab (Prolia).
Fluroride ix?
prophylaxis of dental caries.
Gallium nitrate is currenty FDA approved for?
the management of hypercalcemia of malignancy
The most significant side effect of gallium nitrate is?
nephrotoxicity.
The primary contraindication to using gallium nitrate is ?
severe kidney disease.
What is the MOA of both Gallium Nitrate and Fluoride?
inhibition of osteoclast activity.
MOA of Cinacalcet?
binds and sensitizes CaSR (calcium-sensing receptor) in parathyroid–> decreased PTH
Cinacalcet is indicated for?
the treatment of secondary hyperparathyroidism in chronic kidney disease
Cincalcet is contraindicated in?
patients with hypocalcemia.
How do calcimimetics and Calcilytics differ
mimetics agonize the CaSR
lytics antagonize
The net effect of furosemide?
is to decrease serum calcium levels by excreting calcium in the urine
the main indication for the use of furosemide is?
in the treatment hypercalcemia.
The principal application of hydrochlorothiazide in calcium homeostasis is?
in reducing renal calcium excretion at distal tubule
