Drugs Used to Treat Bone Disorders Flashcards Preview

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Flashcards in Drugs Used to Treat Bone Disorders Deck (24):
1

Which type of bone is preferentially remodelled, trabecular or compact?

Trabecular

2

What is the major cause of hyperphosphataemia?

Renal failure

3

What is the pathophysiology of osteoporosis at a cellular level?

Increase activity and life span of osteoclasts

Decreased life span of osteoblasts and osteocytes

= Larger and deeper resorption cavities in bone = more fragile bone

3

How are biphosphonates administered?

Taken on a weekly basis

5

Which two bones are preferentially effected by pathological remodelling?

Head of femur

Vertebral bodies

6

What is the effect of oestrogen on bone cells?

Decreases the activity of osteoclasts

6

What is the suggested long term treatment regiment for osteoporosis in females?

Start with HRT

Then Raloxifene + Bisphosphonates + PTH + Ca + Vitamin D + RANK-L inhibitors

7

What stimulates osteoblasts to express RANK-L?

Calcitriol

PTH

7

How does oestrogen therapy effect bone mass?

Maintains bone mass

Slows bone breakdown

8

How can PTH therapy work to reduce bone density loss?

Because PTH treatment acutely increase osteoblast activity (whilst continuous high exposure of PTH favours bone catabolism)

9

What is an advantage of SERMs?

It is an antagonist of oestrogen receptors in mammary tissue therefore doesn't carry a breast cancer risk

10

What is the mechanism of action of bisphosphonates?

They are absorbed into bone

Osteoclasts that ingest them are inhibited and apoptosis is promoted

10

What type of drug is denosumab?

A monoclonal antibody RANK-L inhibitor therefore blocks the activation of osteoclasts

11

What type of drug is alendronate?

Bisphosphonate

13

What is the specific definition of osteoporosis?

A reduction of bone mass by greater than 2.5 standard deviations for a 30 year old female

14

What are the two board classes of drugs used in bone disorders? What type of cells do they target

Anti-resorptive: osteoclasts

Anabolic agent: osteoblasts

16

What is the function of embedded cytokines?

Increase the activity of osteoblasts

17

What are the effects of calcitriol?

Increase osteoclast activity

Decrease renal excretion of Ca

Increase intestinal absorption of Ca

19

What are the major side effects of biphosphonates?

Oesphagitis risk - slight cancer risk

Atypical fracture due to remodelling effect

20

What are some bone anabolic agents?

PTH 

Oral calcium

Oral vitamin D analogue 

Oral calcitonin

21

What has replaced oestrogen therapy?

Selective oestrogen receptor modulators (SERMs)

22

What are downsides of oestrogen therapy?

Increase cardiovascular risk and breast cancer risk

23

What happens to the trabecular structure in osteoporosis?

Trabeculae are loss and others are thinned

24

What type of drug is Raloxifene?

A SERM