Welch- PTH, Calcitonin and BPs Flashcards Preview

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Flashcards in Welch- PTH, Calcitonin and BPs Deck (34):
1

2 things that regulate Ca2+ homeostasis

-PTH
-1, 25 dihydroxyvitamin D

2

PTH stimulates what in the kidney mitochondria

1-hydroxylase activity, which leads to increased production of 1, 25 dihydroxyvitamin D (calcitriol) from 25-hydroxyvit D

3

active form of bit D

calcitriol

4

3 main body parts involved in Ca2+ homeostasis

-kidney
-bone
-intestine

5

Ca2+ sensing receptor

CaSR on PTH cells

6

mechanism for CaSR

Low Ca2+ --> binds to open confirmation of CaSR --> GPCR --> PLC --> PKC --> phospholipase A2

7

where is PTH-R1 expressed

-bone osteoblasts
-kidney

8

type of PTH-R1 receptor

GPCR --> Gs --> cAMP --> PKA

9

how does PTH stimulate increased Ca2+ reabsorption in the kidney

PTH increases insertion of Ca2+ channels in the apical membrane to allow Ca2+ entry

10

2 causes of hypoparathyroidism

-accidental surgery
-disease of PT gland

11

tetany, muscle spasms, eventual convulsions and death due to respiratory failure

symptoms of hypoparathyroidism

12

tx for hypoparathyroidism

-vit D analgog w/Ca2+ supplement

13

why is PTH not used therapeutically

unstable

14

main drug used for hypoparathyroidism

Forteo

15

chronic use of forteo

-mimics PTH; activates osteoclasts; hypoparathyroidism

16

intermittent use of forteo

stimulates osteoblasts for osteoporosis

17

hyperplasia of adenoma

causes of primary hyperparathyroidism

18

tx for primary hyperparathyroidism

surgery

19

only cause of Ca2+ and PO4 kidney stone

primary hyperparathyroidism

20

hypercalcemia (muscle weakness), smooth m dysfnction, constipation, gas, anoxia, n+ v

primary hyperparathyroidism symptoms

21

increased secretion of PTH due to low plasma Ca2+ as a result of malabsorption or renal disease

secondary hyperparathyroidism

22

tx for secondary hyperparathyroidism

correct underlying disorder

23

3 body parts needed for vit D pathway

-skin
-liver
-kidney

24

3 enzymes needed for vit D

-UV light
-25-hydroxylase (liver)
-1 hydroxylase (kidney)

25

MOA of calcitonin

-inhibits bone resorption by opposing action of PTH
-calcitonin directly and rapidly inhibits osteoclast motility, and prevents osteoclast differentiation

26

3 therapeutic uses of calcitonin

-lowering hypercalcemia in hyperparathyroidism, idiopathic hypercalcemia and vit D intoxication
-postmenopausal osteoporosis
-Paget's disease

27

3 preparations of calcitonin

-Miacalcin (Sandoz)
-Calcimar
-CIbalcalin (synthetic human calcitonin)

28

-FDA approved for prevention of osteoporosis
-MOA: decreases osteoclast activity

-estrogen therapy

29

-Indication: tx AND prevention of osteoporosis
-MOA: estrogenic effects on bone, antiestrogenic effects on breast and endometrium

Selective estrogen receptor modulators (SERM)

30

Raloxifene (evista)

SERM

31

3 Oral BPs

-Fosamax (alendronate)
-Actonel (Risedronate)
-Skelid (Tiludronate)

32

IV BP

-Zometa (Zoledronic acid)

33

IV/Oral BP

Didrone (Etidronate)

34

MOA of BP

-resemble pyrophosphate
-inhibit osteoclast recruitment and activity on bone surface; decrease osteoclast life span
-alter bone or bone mineralization that reduces its dissolution