Pharm 1 osteoporosis drugs Flashcards
bisphosphonates: MOA vs CI vs adverse effects
bind hydroxyapatite in bone –> clasts take it up for resorption –> dec clast activity and inc clast apop vs hypersensitivity, hypocalcemia, CrCL < 30, esophageal abnlities, can’t sit upright for 30min for oral dose vs esophagitis, GI upset
calcitonin: MOA vs CI vs adverse effects vs drug interactions
binds and inhibits clasts –> dec reabsorption vs hypersensitivity vs arthralgia/joint pain, back pain, ca, rhinitis, epistaxis vs dec lithium efficacy
raloxifene (SERM): MOA vs CI vs adverse effects vs drug interactions
estrogen agonist on bone –> dec clast activity; estrogen antagonist on ut and br tissue –> dec ut and br ca vs DVT, VTE, preg, breastfeeding vs hot flashes, leg cramps, inc VTE risk vs dec warfarin effects
conjugated estrogens/bazedoxifene (SERM): MOA vs CI vs adverse effects vs drug interactions
estrogen agonist on bone –> dec clast activity; estrogen antagonist on ut and br tissue –> dec ut and br ca vs DVT, VTE, preg, breastfeeding, hepatic impairment vs GI upset, muscle spasms, sore throat, dizziness, inc risk of br/endometrial ca, inc risk of VTE/stroke, dementia vs don’t use w/ additional estrogen
teriparatide: MOA vs CI vs adverse effects vs drug interactions
recombinant PTH –> inc blast activity –> new bone formation vs hypersensitivity, hypercalcemia, inc risk of osteosarcoma/Paget’s/bone metastases vs hypoTN, leg cramps, GI upset, inc risk of osteosarcoma vs digoxin toxicity if paired w/ digoxin
denosumb: MOA vs CI vs adverse effects vs drug interactions
monoclonal ab inhibiting RANKL –> dec clasts and their activity vs hypersensitivity, hypocalcemia, preg vs high chol, fatigue, GI upset, MSK pain, osteonecrosis of jaw, atypical femur fx vs use w/ tofacitinib –> inc risk of additive immunosuppression
romosozumab-aqqg: MOA vs CI vs adverse effects
inhibits sclerostin –> inc bone formation and dec resorption vs hypocalcemia, MI, stroke vs arthralgia, HA, inc risk of MI/stroke/cardiovasc death
