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28 Cards in this Set

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Effects on Phosphate reabsorption

Contraction
Parathyroid hormone
Dietar Phosphate restirction
Glucocorticoids
contraction increases
parathyroid decreases
phosphate restrictions increases
glucocorticoids decrease
Osteoclasts
Giant multinucleated cells related to monocytes and macs
Marker enzyme for Osteoclasts
TRAP
Osteoblasts
Mesenchymal stem cells
related to fibroblasts
Marker enzyme for osteoblasts
alkaline phophatase
IL-1, TNF alpha and Estrogen effects on osteoclastogenesis
IL-1, TNF alpha increase it
Estrogen decreases (case of osteoporosis in post-menopausal women
PTH
Minute to Minute Ca regulation

T1/2 5-8 mins

Increase Ca reabsorption
Increase Vit D
Stim Osteoblast to stim Osteoclast to resorb bone
Teriparatide
injectable PTH

Halt osteoporosis
Cholecalciferol
Vitamine D3

Formed in the skin by UV light
Ergocalciferol
Vitamin D2

dietary supplements
Calcifediol
25 OHD3

Formed in liver
Main viatmin D compound
Good indication of Vit D status in individual
Calcitriol
1,25 (OH)2D3

Formed in renal mitocondira of PT

Most potent metabolite of Vit-D
Use of vitamin D in early stage renal failure
up regulates its own recetor to prevent resistance to Vit D in target cells

(renal failure, increase PO4, decreases Vit D)
Ectopic produce of Vit D occurs in what inflammatory condition
Granulomatous conditions (sarcoid, TB, candida, lymphoma)
Uses for Vit D
Nutritional Rickets
Osteomalacia
Metabolic Rickets
HypoPTH
Renal Osteodystrophy
Psoriasis
Side Effects of Vit D drugs
Hypercalcemia
Dehydration (antag ADH)
Congenital aortic stenosis
4 Bisphosphonates
Etidronate (oral and IV)
Pamidronate (IV)
Alendronate (oral)
Risendronate (oral)

inhibit osteoclasts
Paget's Disease
Calcitonin
Bisphosphonates
Bisphosphonates use
Pagets Disease (6 month course, itnermittently to prevent osteomalacia)
Humoral hypercalcemia of Malignancy
Osteoporosis
Bisphos for hyperCa of malignancy
Pamidronate IV
Biphos for Osteoporosis
Aledronate (Risendronate also ok)
CI's of bisphosphonates
1st gen may cause weak bones if not given intermittently

3rd gen cause Upper GI symtoms

Avoid in paties with dysphagi, gastritis, duodenitis, ulcers

Not for pt's with renal problems

Correct hypocalcemia first
Do this before treating with bisphosphonates
Correct hypocalcemia if present
Function of Calcitonin
Decrease Ca PO4
Directly inhibits osteoclastis

Works within 6-10 hours
Uses for Calcitonin
Pagets disease (also works as analgesic)
Emergency Tx of hypercalcemia (after volume expansion and furosemide)
Post-menopausal osteoporisis (with Ca)
Rauloxifin
Estrogen for bone only, not breast or uterus
Problem with estrogen plus calcium
May cause endometerial cancer
Dihydroactachysterol
A derivative of D2 that does not need hydroxylation in the kidney

Perfect supplement for patients with renal failure