Pharm- Osteoporosis

Question 1

Salmon Calcitonin
MOA
Uses (what is a limitation?)

Answer 1

Salmon Calcitonin
MOA- dec bone resorption
Uses- osteoporosis and pagets disease- not preventative

Question 2

Alendronate (biphosphanates)
MOA
Uses
AE

Answer 2

Alendronate
MOA- incorporated into bone and prevents resorption
Uses- 1st choice for post-meno osteoporosis, men w/ osteoporosis, glucocorticoid induce osteoporosis, pagets, and malig assoc hyperCa
AE- esophagitis, osteonecrosis of jaw, and atypical femur fracture

Question 3

Raloxifene
MOA
Uses
AE

Answer 3

Raloxifene
MOA- SERM- estrogenic effects in bone and antiestrogenic effects in uterus and breast
Uses- post-menopaus osteoporosis
AE- DVT, PE, stroke

Question 4

Teriparatide
MOA
Kinetics
Uses
AE

Answer 4

Teriparatide
MOA- mimics PTH; inc bone resporption (osteoclast) and bone deposition (osteoblast)
Kinetics- pulse therapy favors osteoblast activity to inc bone formation
Uses- post-meno osteoporosis, men w/ osteoporosis, glucocorticoid osteoporosis
AE- transient inc in Ca, Mg, and uric acid

Question 5

Denosumab
MOA
Uses (what do you combo treat w/)
AE

Answer 5

Denosumab
MOA- inhibits RANKL to dec osteoclast formation/activity
Uses- post-meno osteoporosis in pt w/ high risk of fracture and to prevent skeletal events in pt w/ bone metastases; use w/ Ca and vitD
AE- pain, slow fracture healing, osteonecrosis of jaw, hypercholesterolemia

Question 6

What are the 1st and 2nd choice for treating men w/ osteoporosis? What is the major risk factor and what do you have to combo treat w?

Answer 6

1st choice are bisphosphonates; 2nd choice denosumab

Hypogonadism is major risk thus pt need testosterone replacement

Question 7

Cinacalcet
MOA
Uses
AE

Answer 7

Cinacalcet
MOA- bind CASR to inc sensitivity and dec PTH release
Uses- hyperparathyroidism
AE- NV diarrhea

Question 8

How do you treat osteomyelitis and for how long?

Answer 8

Treat underlying pathogen w/ antibiotics for 4-6 weeks