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17 Cards in this Set
- Front
- Back
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DOC for osteoporosis
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Bisphosphonates
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Various methods of tx osteoporosis
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HRT
Calcitonin Selective E R modulators Bisphosphonates |
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MOA HRT (LD estrogen)
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Inhibit osteoclast activity
(Increase HDL, decrease LDL, decrease vasomotor symptoms of menopause) |
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What do you have to also give with LD estrogen? Why?
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Progesterone (if haven't had hysterectomy)
Increased risk endometrial hyperplasia and cancer |
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MOA Calcitonin
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Direct inhibitor osteoclasts
Calcitonin R on osteoclasts --> cAMP --> inhibits resorptive abilities |
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How is calcitonin given
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NOT orally effective
Given IV, subQ, intranasal |
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Use Calcitonin
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IV - osteoporosis-mediated fx (analgesic properties)
Paget's disease Acute tx hypercalcemia |
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Use Tamoxifen? Why?
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Breast Ca prevention in women at high-risk whom have had hysterectomy
(increased risk for endometrial CA) |
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Use Raloxifene
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Prevent or tx osteoporosis
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SE SERMs
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DVT & PE
Increases hot flashes & leg cramps |
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Use bisphosphonates
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DOC for prevent osteoporosis in osteopenic pt, tx osteoporosis, Paget's disease
DOC chronic hypercalcemia from malignancy DOC osteolytic bone metastases |
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Why do you not give Ca with bisphosphonates
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Will bind Ca in GI tract and be excreted out with feces
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Long-term use SE bisphosphonates
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Long-term use - development of osteomalacia
(drug holidays every few yrs) |
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MOA bisphosphonates
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Inhibits farnesyl diphosphate synthase
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SE bisphosphonates
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Heartburn, N/Abd pain
Erosive esophagitis (Must remain upright for > 30 min after administration) |
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What are some bisphosphonates
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Aldendronate - qd or qwk
Etidronate - daily Ibandronate - daily, monthly, q3 mos Pamidronate - q3 mos Risedronate - daily or wkly Tiludronate - Paget's dz only Zoledronic acid - q yr |
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Contraindications to bisphosphonate use
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Poor renal function
Inability to be upright for at least 30 mins Hx esophageal or gastric d/o Inflammatory problems of jaw or gums (risk for necrosis) |
