Lecture 24

Question 1

Osteoporosis gender disparities

Answer 1

1 in 3 women, 1 in 5 men over 50 yrs

Question 2

Bisphosphates

Answer 2

Group of drugs that bind to bone matrix and is cleaved from the system. One infusion/year. Primary cell affected is osteoclasts as it ingests bisphosphates preventing them from reabsorbing bone. Increases BMD and decreases fracture risk. decrease CTX and P1NP.

Question 3

Denosumab

Answer 3

Binds to RANKL receptors to prevent differentiation of osteoC precursor cells. Bianually subcutaneous injections. Increase BMD and decreases bone turnover, CTX, P1NP, fracture risk. When stopped out after 5 yrs, rapid decrease BMD due to overshoot of osteoC.

Question 4

Parathyroid Hormone therapies

Answer 4

targets increasing osteoB activity. Decrease Ca = PTH secretion = bone reabsorption. Continuous PTH = increased bone reabsorption. But, daily PTH (peak then back to low or normal levels) = overall anabolic effects.

Question 5

osteocytes

Answer 5

regulate osteoB and osteoC activity. Secrete RANKL which promotes osteoC formation and sclerostin which inhibit onsteoB formation. New agent can inhibit sclerostin, increase osteoB formation = increase bone formation. Anti-sclerostin antibody. Monthly injections increases BMD through increase P1NP and decrease CTX. Drug has limited capacity therefore, rest period before charting again to increase affect (not long time)