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13 Cards in this Set

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Drugs used for Osteoporosis
1. Dietary Calcium & Vitamin D
2. Estrogen replacement therapy & Use of estrogen receptor agonists
3. Parathyroid Hormone
4. Calcitonin
5. Fluoride
6. Bisphosphonates
Alendronate
(FOSAMAX)
Bisphosphate
Ibandronate
(BONIVA)
Bisphosphate
Tiludronate
(SKELID)
Bisphosphate
Etidronate
(DIDRONEL)
Bisphosphate

IV infusion used for hypercalcemia and Osteoporosis
Risedronate
(ACTONEL)
Bisphosphate
Zoledronate
(ZOMETA)
Bisphosphate

Rare Renal Dysfunction
Bisphospate drugs (6)
Alendronate (FOSAMAX)
Ibandronate (BONIVA)
Tiludronate (SKELID)
Etidronate (DIDRONEL)
Risedronate (ACTONEL)
Zoledronate (ZOMETA)
Bisphosphate

-MOA
MOA
-inhibits osteoclastic activity through apoptosis (non-hydrolysable ATP analog) &
-interferes with cholesterol synthesis (farnesyl synthase) in the osteoclast.
Bisphosphates

-Kinetics
-Chronic Treatment
Kinetics
-Have high affinity for Ca in bone matrix.
-long half-life (infrequent dosing)
-in the design of the bisophosphonate drugs, there is a chemical replacement of teh oxygen of teh pyrophosphate bond with a carbon.

Chronic treatment enhances bone mass in osteoporosis
Bisphosphates

-Adverse Effects
-Counterindication
-Oral admin: GI irritation and poor absorption
-Cytokine release upon parenteral infusion (fever, aches, flu-like syndrome)
-Rare renal dysfunction (zolendronate)
-Rare adverse effect: cellular necrosis & osteomalacia in mandibular structures.

Counterindication: Pregnancy
Drug treatment for Hypercalcemia
1. Saline Diuresis (followed by furosemide, if necessary)
2. Bisphosphates (etidronate & pamidronate) as IV infusion
3. Calcitonin
4. Gallium nitrate
5. Phosphate
pamidronate
Bisphosphate

IV infusion used for hypercalcemia and Osteoporosis