Flashcards in Drugs for Bone Deck (20):
How much bone gets remodelled per year?
25% trabecular bone
3% cortical bone
Which bones are preferentially affected by bone remodelling?
T/F PTH affects both the activity of osteoblasts and osteoclasts
T/F Oestrogen preferentially targets osteoblasts
False, they decrease osteoclast activity
How does glucocorticoids affect bone cells?
increase osteoclast activity and decrease osteoblast activity
What is the clinical definition of osteoporosis?
reduction in bone mass more than 2.5 standard deviation below the norm for healthy 30 year old women
a less severe form of osteoporosis, only 1 to 2.5 standard deviation below the norm
How does osteoporosis cause back pain?
Target the vertebral body, reduction in the trabecular density, leading to microfractures and pain
What are the three antiresorptive agents?
selective oestrogen receptor modulator
What is bisphosponate an analogue of?
analogue of pyrophosphate, but enzyme resistant
Describe the pharmacokinetic of bisphosponate
incorporated into bone matrix and accumulate at the site of bone mineralisation for long periods
ingested by osteoclasts to promote apoptosis and recruitment of more osteoclasts
How often do you administer bisphosponate? What's the main side effect of this drug?
How does bisphosponate cause atypical fractures
It interrupts function of osteoclasts, hence the remodelling process of bone
How does oestrogen protect women from osteoporosis
promote osteoclast apoptosis
increase life span of osteoblasts and osteocytes
maintain bone mass
Why has oestrogen receptor modulators replaced direct oestrogen administration?
Oestrogen causes CVD and breast cancer
What's the action of raloxifene?
It's an oestrogen receptor modulator
agonist at oestrogen receptor in bone and CV tissues
antagonist at oestrogen receptor in mammary tissue and uterus
What is Denosumab
a RANK ligand inhibitor on osteoblasts, inhibiting osteoclast maturation
How is the action of PTH different in prolonged dose as opposed to acute dose
acute dose - activate osteoblast
prolonged - activate osteoclast
What is the side effect of taking anabolic calcium?