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28 Cards in this Set
- Front
- Back
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Effects on Phosphate reabsorption
Contraction Parathyroid hormone Dietar Phosphate restirction Glucocorticoids |
contraction increases
parathyroid decreases phosphate restrictions increases glucocorticoids decrease |
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Osteoclasts
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Giant multinucleated cells related to monocytes and macs
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Marker enzyme for Osteoclasts
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TRAP
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Osteoblasts
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Mesenchymal stem cells
related to fibroblasts |
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Marker enzyme for osteoblasts
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alkaline phophatase
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IL-1, TNF alpha and Estrogen effects on osteoclastogenesis
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IL-1, TNF alpha increase it
Estrogen decreases (case of osteoporosis in post-menopausal women |
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PTH
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Minute to Minute Ca regulation
T1/2 5-8 mins Increase Ca reabsorption Increase Vit D Stim Osteoblast to stim Osteoclast to resorb bone |
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Teriparatide
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injectable PTH
Halt osteoporosis |
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Cholecalciferol
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Vitamine D3
Formed in the skin by UV light |
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Ergocalciferol
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Vitamin D2
dietary supplements |
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Calcifediol
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25 OHD3
Formed in liver Main viatmin D compound Good indication of Vit D status in individual |
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Calcitriol
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1,25 (OH)2D3
Formed in renal mitocondira of PT Most potent metabolite of Vit-D |
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Use of vitamin D in early stage renal failure
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up regulates its own recetor to prevent resistance to Vit D in target cells
(renal failure, increase PO4, decreases Vit D) |
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Ectopic produce of Vit D occurs in what inflammatory condition
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Granulomatous conditions (sarcoid, TB, candida, lymphoma)
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Uses for Vit D
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Nutritional Rickets
Osteomalacia Metabolic Rickets HypoPTH Renal Osteodystrophy Psoriasis |
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Side Effects of Vit D drugs
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Hypercalcemia
Dehydration (antag ADH) Congenital aortic stenosis |
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4 Bisphosphonates
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Etidronate (oral and IV)
Pamidronate (IV) Alendronate (oral) Risendronate (oral) inhibit osteoclasts |
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Paget's Disease
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Calcitonin
Bisphosphonates |
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Bisphosphonates use
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Pagets Disease (6 month course, itnermittently to prevent osteomalacia)
Humoral hypercalcemia of Malignancy Osteoporosis |
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Bisphos for hyperCa of malignancy
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Pamidronate IV
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Biphos for Osteoporosis
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Aledronate (Risendronate also ok)
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CI's of bisphosphonates
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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 |
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Do this before treating with bisphosphonates
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Correct hypocalcemia if present
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Function of Calcitonin
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Decrease Ca PO4
Directly inhibits osteoclastis Works within 6-10 hours |
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Uses for Calcitonin
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Pagets disease (also works as analgesic)
Emergency Tx of hypercalcemia (after volume expansion and furosemide) Post-menopausal osteoporisis (with Ca) |
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Rauloxifin
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Estrogen for bone only, not breast or uterus
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Problem with estrogen plus calcium
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May cause endometerial cancer
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Dihydroactachysterol
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A derivative of D2 that does not need hydroxylation in the kidney
Perfect supplement for patients with renal failure |
