Cology, Bone, Ca Related Drugs

Front 1

normal plasma values for ca

Back 1

8.8 to 10.4 mg/dl

2.15 to 2.65 mM/L

Front 2

3 variables in ca homeostasis

Back 2

intake

excretion

exchange w/ reservior

Front 3

critical values

Back 3

< 6 mg/dl

> 14 mg/dl

Front 4

< 6 mg/dl s/s

Back 4

depolarization:

tetany

spontaneous contraction

seizures

Front 5

< 6 mg/dl

more or less bound

acidosis/alkalosis

Back 5

more bound

alkalosis (less ions)

Front 6

> 14 mg/dl s/s

Back 6

hyperpolarization

decreased firing rates

lethargy

weakness

Front 7

> 14 mg/dl

bound/unbound

acidosis/alkalosis

Back 7

decreased bound

acidosis

more ions

Front 8

calciferols --- and --

Back 8

vit d

metabolites

Front 9

major tx uses of calciferols

prophylaxis and crue of -- ----

tx of metabolic --- and ------

Back 9

nutritional rickets

metabolic rickets

osteomalacia

Front 10

calciferols

tx of --- due to ----

Back 10

hypocalcemia

hypoparathyroidism

Front 11

calciferols

prevention and tx of ---

Back 11

osteoporosis

Front 12

ergocalciferol is pure ---

Back 12

vit D2

Front 13

route of ergocalciferol

Back 13

oral

iv

im

Front 14

ergocalciferol ci in -- disease

Back 14

liver

kidney

(cuz can't hydroxylate)

Front 15

active form of vit d

Back 15

1, 25

Front 16

inert form of vit d

Back 16

24, 25

Front 17

calcifediol

normally produced in the ------

metabolic precursor of ---

Back 17

liver

1,25 (OH)2 D3

Front 18

calcifediol

route

ci in:

Back 18

oral

ci in kidney disease

Front 19

calcitriol:

quick/slow acting

route:

used in -- failure

Back 19

quick

oral/injectable

renal failure

Front 20

dihydrotachysterol (DHT)

vit --- analog

Back 20

D2

Front 21

t/f

dihydrotachysterol (DHT) less effective than vit d in mobilizing bone mineral

Back 21

f

more effective

Front 22

dihydrotachysterol (DHT)

used to maintain ---- in hypoparathyroidism

Back 22

plasma Ca

Front 23

which break down old bone

Back 23

osteoclast

Front 24

which lay new bone

Back 24

osteoblast

Front 25

calciferols

vit d bind to -- receptors, complex enters ----- ( a steroid hormone) and leads to proteins synthesis

Back 25

cytosolic

nucleus

Front 26

calciferols

increases -- absorption from gi

Back 26

ca

it's major action

Front 27

what antagonizes calciferols

Back 27

glucocorticoids

Front 28

what's involved in absorption

Back 28

IMCal

calbindin

Ca-ATPase

Front 29

calciferols stimulates bone resoption oby ----

also decrease -- ---- by osteoblast

Back 29

osteoclast

osteoblast

Front 30

calciferols critical for -- of new bone

Back 30

mineralization

Front 31

calciferols

increase uptake of ca by --- of -- ---

Back 31

SR

skeletal muscle

Front 32

calciferols

decreases -- levels

Back 32

PTH

Front 33

IMCal located on --- --

------ protein that gets vit D out of Gi tract into cytoplasm

Back 33

brush border

transport

Front 34

recommended ca for kids

Back 34

800-1200 mg

Front 35

adolescents ca recommendation

Back 35

1200-1500 mg

Front 36

ca recommended

men 25-65

> 65

Back 36

1000mg

1500 mg

Front 37

ca recommended

women

25-65

> 50 postmen + estrogen

> 50 postmen + no estrogen

Back 37

1000 mg

1000 mg

1500 mg

Front 38

women preg and nursing

Back 38

1200 - 1500 mg

Front 39

calciferols given to:

Back 39

maintain plasma Ca levels

Front 40

calcitonin from --- cells

Back 40

parafollicular cells

Front 41

calcitonin lowers --- and --- levels in hyperca

Back 41

ca

phosphate

Front 42

calcitonin

decreases bone ----

Back 42

resorption (osteocytic osteolysis, osteoclastic bone resorption)

major effect!

Front 43

calcitonin

decrease renal -- and --- reabsorption

Back 43

PO 4

Ca

Front 44

calcitonin tx

Back 44

paget's disease

osetoporosis

metastitc hypercalcemia

Front 45

paget's disease: acceleration o f --- acitivy coupled w/ increased but ---- bone formation

Back 45

osteoclast

disorganized

Front 46

calcitonin ci in

Back 46

fish hypersensitivity (calcimar)

pregnancy or breat feeding

Front 47

t/f

cibacalcin still used

Back 47

f

Front 48

ciabcalcin -- form

Back 48

human

Front 49

ciabcalcin

what's potent:

synthetic or natural

Back 49

synthetic

Front 50

calcimar

-- form

Back 50

salmon

Front 51

calcimar route

Back 51

sc

im

Front 52

calcimar has unexplained -- effect

Back 52

analgesic

Front 53

miacalcin

route

Back 53

nasal

Front 54

miacalcin

reduced/increased bioavailability

Back 54

reduced bioavailability

Front 55

miacalcin has more potent/rapid -- effect

Back 55

analgesic

Front 56

miacalcin

may produce --- tis


--- bleed

-- pain

-- ache

Back 56

rhinitis

nosebleed

back pain

headache

Front 57

biphosphonates inhibitis --- ---

Back 57

bone resorption

Front 58

biphosphonates promotes modes increa in -- --- mass

Back 58

spinal bone

Front 59

biphosphonates txs

Back 59

paget's disease

metastatic hypercalcemia

postmenopausal osetoporosis

Front 60

biphosphonates ci

-------calcemia

---- abnormalities

----- individuals

----- insufficiency

Back 60

hypocalcemia

esophageal abnormalities

bedridden individuals

renal insufficiency

Front 61

why bisphosphonates and bedridden/esophageal abnormalities CI

Back 61

due to cytotoxic effects. . .if gets caught can cause damage

Front 62

sodium etidronate

synthetic analog of

Back 62

pyrophosphate

Front 63

sodium etidronate reserved for pts w/ -- to -- paget's diease

--calcemia associated w/ malignant ----

Back 63

moderate to severe

hypercalcemia

neoplasms

Front 64

sodium etidronate

may be used in --- pt htat have extensive bone damage that may jeopardize joints

Back 64

asymptomatic

Front 65

sodium etidronate routes

Back 65

oral

parenteral

Front 66

sodium etidronate

poorly/well absorbed

Back 66

poorly absorbed

Front 67

sodium etidronate

rapidly concentrated in the ---

Back 67

bone

so less peripheral toxicity cuz pulled into bone quickly

Front 68

sodium etidronate

susceptible/resistant to metabolism

Back 68

resistant

cuz almost all goes into the bone

Front 69

2nd gen bisphos

Back 69

alendronate

Front 70

alendronate is the first member to -- bone rather than simply prevent bone loss

Back 70

strengthen

Front 71

alendronate

does not inhibit one --- like 1st gen

Back 71

mineralization

Front 72

alendronate

approved for tx of

Back 72

postmenopausal osteoporosis and paget's

Front 73

alendronate

alleviates -- pain

Back 73

bone (paget's)

Front 74

alendronate

under investigatin for tumor induced ---

Back 74

hypercalcemia

Front 75

alendronate

bioavailability:

Back 75

less than 1%

Front 76

alendronate dose

Back 76

q week (long 1/2)

take when fasting

Front 77

rare se of alendronate

Back 77

jaw deterioration

Front 78

pamidronate:

-- gen

Back 78

2nd

Front 79

pamidronate: route

Back 79

parenteral

Front 80

pamidronate:

rapidly/slowly concentrated in the bone

Back 80

rapidly

Front 81

pamidronate:

reserved for

Back 81

refractory paget's

hypercalcemia from malignant neoplasms

hyperparathyroidism resulting in mod to sever bone pain

Front 82

pamidronate:

cheap/expensive

Back 82

expensive

Front 83

ibandronate

-- gen

Back 83

3rd gen

Front 84

ibandronate

reduces -- fx due to osteoporosisi

Back 84

vertebral

Front 85

ibandronate

1st line tx for ---

Back 85

osteoprosis

Front 86

ibandronate

under investigation for --- and ---

Back 86

malignant hypercalcemia

paget's

Front 87

ibandronate

administration

Back 87

injected q 3 mo

better compliance

Front 88

risedronate

can be taken when?

Back 88

daily

weekly

or on two consecutive days q month

Front 89

t/f

ok to take risedronate w/ food or drink

Back 89

f

poorly absorbed

(take w/ water)

Front 90

risedronate

has faster/slower esophageal transit time

Back 90

faster

so good for esophageal probs

Front 91

more chances of hip fx:

risedronate or alendronate

Back 91

alendronate

Front 92

zoledronic acid

route

gen

Back 92

IV

3rd gen

Front 93

which more potent

zoledronic acid or panidronate

Back 93

zoledronic acid

Front 94

zoledronic acid

administration

Back 94

5 mg

q year

Front 95

Too much aldosterone is what syndrome?

Back 95

Conn's or overactive renin angiotensin system

Front 96

zoledronic acid

can cause

Back 96

a fib

nephrotoxic

Front 97

zoledronic acid

reduces -- and -- fx

Back 97

vertebral

hip

Front 98

fluoride

used to tx --- and -- bone disease

Back 98

osteoporosis

neoplastic

Front 99

fluoride

increase vertebral bone ---- by about 10% per year

Back 99

mass

Front 100

fluoride

tx doses increase the number of --

Back 100

osteoblasts

no only does it slow down bone resorption but also increase bone mass

Front 101

fluoride

subs -- and -- for hydroxyapatite

Back 101

fluorapatite

fluorhydroxyapatite

Front 102

fluoride

low doses stimlate -- --- formatin

Back 102

new bone

Front 103

always combine fluoride w/

Back 103

calcium

vit d

estrogen

Front 104

raloxifene

selective -- --- --

Back 104

estrogen receptor modulator

Front 105

raloxifene

fda approved for prevention of

Back 105

osteoporosis

Front 106

raloxifene

produce -- increase in bone density

Back 106

modest

Front 107

raloxifene

reduces risk of --- --- ---

Back 107

verterbral compression fx

Front 108

raloxifene


increase risk of

Back 108

clot formation

Front 109

vit k

low in -- --- victims

Back 109

hip fx

Front 110

vit k necessary for

Back 110

blood clotting

Front 111

vit k

K1 provided by:

K2 provided by:

Back 111

K1: diet

K2: made by the gut (abx can interfere)

Front 112

estrogen replacement

-- and -- of osteoporosis

Back 112

prevention

tx

Front 113

teriparatide

-- hormone

Back 113

parathyroid

Front 114

teriparatide

administration

Back 114

intermittent

sq

low dose injection stimulate both trabecular and cortical bone formation

Front 115

teriparatide

low dose injection stimulate both --- and ---- bone formation

Back 115

trabecular

cortical

Front 116

teriparatide

must be injected intermittently in relatively --- ----

Back 116

small boluses

Front 117

teriparatide

may prove to be effective tx for -- and other -- --- disorders

Back 117

osteoporosis

bone related disorders

Front 118

parathyroid hormone release controlled by

Back 118

ca levels

Front 119

parathyroid hormone

kidney

ncrease ---- resoprtion

increase production of -----

Back 119

tubular

1,25

Front 120

parathyroid hormone

bone

increase -- ---

increae --bone resorption

Back 120

osteocytic osteolysis

osteoclast

Front 121

parathyroid hormone

increases --- absorption by increasing -- in the gi

Back 121

ca

1,25

Front 122

parathyroid hormone

increase --- levels

Back 122

ca

Front 123

cinacalcet

mimics the -- -- of calcium to inhibit pth secretion

Back 123

stimulatory effect

Front 124

cinacalcet

a -- derivative

Back 124

phenyalkylamine

Front 125

cinacalcet

approved for tx of -----

Back 125

hyperparathyroidism

Front 126

cinacalcet

provides sustained normalization of serum - w/o altering --- --- --

Back 126

ca

bone mineralization density

Front 127

cinacalcet

may produce -- calcemia

Back 127

hypocalcemia

Front 128

cinacalcet

may interact w/ drug aht regulate --- ---

Back 128

ca homeostatsis

Front 129

t/f

osteoporosis is a disease

Back 129

f

a condition