Lecture 73 Micronutrients Pharm

Question 1

Cholecalciferol

Uses/treats, MOA, results, limitations

Answer 1

Vit D3, animal form of Vit D
Used for replacement therapy to prevent treat osteomalacia/rickets
Converts to active form through endogenous regulation
Also increases Ca, PO4 absorption
Wont be effective during renal failure

Question 2

Ergocalciferol

Answer 2

Vit D2, plant form of Vit D

Question 3

Vit D pathway

Answer 3

Skin/Diet
Vit D3/ Vit D2
Vit D--> liver
P450 of liver mass action
25(OH)D    (Vit D levels measurement) (direct precursor of active form)
1,25(OH)2D  --"calcitriol"  active form

Question 4

Sunscreen effect

Answer 4

may block adequite Vit D formation (bc cant absorb from sunlight)

Question 5

Calcitriol MOA

Answer 5

Agonist for VDR (Vit D receptor)
Most VDR’s are nuclear, some membrane-locailized
Once bound regulates gene tx

Question 6

25(OH)D problem

Answer 6

At very high levels can interact w VDR’s causing hypercalemia (maybe soft tissue calcification)

Question 7

Calcitriol

uses, side effect

Answer 7

Used in time of renal failure (bc Vit D3 would not be able to be converted to active form) for hypocalcemia and hyperparathroidism
**Can cause HYPERcalcemia bc it bypasses feedback regulation that maintain normocalcemia levels

Question 8

Cinacalcet

uses, MOA, adverse effects

Answer 8

2ndary hyperparathyroidism in renal disease
Primary hyperparathyroidism
(sometimes) parathyroid carcinoma
CaSR (Ca-sensing receptor) activator
Allosteric (away from active site) modulator of Ca receptor- enhances response to Ca, decreases PTH release
Side effect- hypocalcemia

Question 9

Teriparatide

use, struct, MOA

Answer 9

Used to promote bone formation in severe osteoporosis (no matrix or mineral)
Human PTH 1-34
given as dose making “spikes” of PTH- yielding net bone formation
(chronic high PTH- causes net bone resorption)

Question 10

Calcitonin

(use, MOA

Answer 10

Adjunct drug for osteoporosis

Inhibits osteoclastic activity via direct suppression of osteoclastic activity