bisphosphonates MOA
1st line
pyrophosphate analogs, bind hydroxyapatite –> taken up by osteoclasts –> osteoclast apoptosis
bisphosphonates AE
atypical femur fractures (below lesser trochanter)
osteonecrosis of jaw
GI upset
flu-like sx
Teriparatide MOA
recombinant PTH
Teriparatide AE
theoretical osteosarcoma
raloxifene MOA
SERM
calcitonin MOA
Denosumab
monoclonal RANK-L Ab
blocks osteoblast activity of osteoclasts
does not get incorporated into bone
romosozumab
MAb to sclerostin (protein secreted by osteocytes that inhib formation of bone)
antiresorptives
bisphosphates
SERM (Raloxifene)
Denosumab
Estrogen therapy
anabolics
teriparatide
abaloparatide
Ramosozumab
abaloparatide
rPTHrP