Bone

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Author:
Anonymous
ID:
94723
Filename:
Bone
Updated:
2011-07-20 20:04:09
Tags:
Bone pharm
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Description:
Block 4 May 2011
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  1. What's the only drug that increases bone formation?
    Teriparatide -- does not try to block bone resorption, as all other osteoporosis drugs do.
  2. 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?
    Doxercalciferol
  3. What is a synthetic analog of active vitamin D2 that is used to treat secondary hyperparathyroidism associated with chronic renal failure?
    Paricalcitol
  4. Commonly used to prevent and treat osteoporosis, rickets and osteomalacia
    Calcitriol = active vitamin D
  5. What is dihydrotachysterol?
    A synthetic analog of active vitamin D
  6. Name a drug used to treat psoriasis
    Calcipotriol or Calcipotriene = topical derivative of calcitriol
  7. 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 .
  8. Uses of bisphosphonates
    • Osteoporosis (even induced by steroids).
    • Paget’s disease of bone.
    • Hypercalcemia of malignancy.
  9. Adverse effects of bisphosphates
    • Esophagitis
    • GIT distress
    • Osteonecrosis of the jaw
  10. Estrogen use in osteoporosis
    Inhibit IL-1 and TNF and thus decrease osteoclasts differentiation/activation
  11. 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
  12. When is calitonin secreted? From where?
    Secreted in response to increases in plasma calcium by the parafollicular cells of the thyroid gland
  13. 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
  14. Uses of calcitonin
    • Tx of Paget's disease
    • Postmenopausal osteoporosis
    • Hypercalcemia
  15. Effects of flouride
    • Stimulates new bone formation
    • Increases bone crystal size and renders the bone more resistant to resorption
  16. A monoclonal Ab for Tx of osteoporosis
    Denosumab
  17. 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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