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What's the only drug that increases bone formation?
Teriparatide -- does not try to block bone resorption, as all other osteoporosis drugs do.
What is a synthetic vitamin D2 analong that undergoes metabolic activation in vivo to form active vit D2 that is used to treat secondary hyperparathyroidism associated with chronic renal failure?
What is a synthetic analog of active vitamin D2 that is used to treat secondary hyperparathyroidism associated with chronic renal failure?
Commonly used to prevent and treat osteoporosis, rickets and osteomalacia
Calcitriol = active vitamin D
What is dihydrotachysterol?
A synthetic analog of active vitamin D
Name a drug used to treat psoriasis
Calcipotriol or Calcipotriene = topical derivative of calcitriol
Mechanisms of bisphosphates
- -- have P-C-P which is nonhydrolyzable compared to Pyrophosphate P-O-P found in
- bone hydroxyapatite --> P-O-P easily destroyed by osteoclasts
- -- adsorb to hydroxyapatite and become a part of the bone structure.They are slowly released from the bone during the bone remodeling. Biphosphonates prevent bone resorption by inhibiting
- osteoclast activity
- – Prevent attachment of osteoclast to bone.
- – Decrease the activity of osteoclast .
Uses of bisphosphonates
- Osteoporosis (even induced by steroids).
- Paget’s disease of bone.
- Hypercalcemia of malignancy.
Adverse effects of bisphosphates
- GIT distress
- Osteonecrosis of the jaw
Estrogen use in osteoporosis
Inhibit IL-1 and TNF and thus decrease osteoclasts differentiation/activation
A selective estrogen receptor modulator and its uses
Raloxifene -- used for prevention/treatment of osteoporosis in women -- decreases osteoclast activity w/o increasing osteoblast activity
When is calitonin secreted? From where?
Secreted in response to increases in plasma calcium by the parafollicular cells of the thyroid gland
Effects of calcitonin
- Main effect = to lower serum calcium and phosphate
- Inhibits osteoclast activity, decreases bone resorption and reduces bone pain
- Inhibits the reabsorption of calcium and phosphate from the renal tubules
Uses of calcitonin
- Tx of Paget's disease
- Postmenopausal osteoporosis
Effects of flouride
- Stimulates new bone formation
- Increases bone crystal size and renders the bone more resistant to resorption
A monoclonal Ab for Tx of osteoporosis
Mechanism of denosumab
Binds RANKL on osteoblasts which then prevents osteoblasts from binding RANK on pre-osteoclasts and forming mature osteoclasts -- thereby protects bone from osteoporosis
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