Pharm: Drugs Affecting Bone Mineralization

Front 1

Name 2 functions of thyroid hormones.

Back 1

1. control metabolism
2. promote normal growth and development

Front 2

Name 2 functions of parathyroid hormones.

Back 2

1. regulate calcium homeostasis
2. maintain proper bone mineralization

Front 3

What is the function of the thyroid gland?

Back 3

synthesizes 2 hormones (thyroxine--T4 and triiodothyronine--T3)

Front 4

How are T4 and T3 synthesized?

Back 4

by adding iodines to the tyrosine residues

Front 5

Does T4 or T3 have a higher plasm concentration? Effect on target tissues?

Back 5

T4 has a higher plasma concentration

T3 has a higher effect on target tissues

Front 6

Describe the regulation of thyroid hormone release.

Back 6

the production is controlled by the hypothalamic-pituitary system in a negative feedback loop

- increased thyroid hormones loop back to inhibit the pituitary and the hypothalamus

Front 7

What are 4 physiological effects of the thyroid hormones?

Back 7

1. growth and metabolism -- bone/CNS
2. metabolic effects -- increase glucose/lipid availablility
3. thermogenesis -- increase BMR/heat
4. cardiovascular effects -- inc HR and cardiac contractiity, inc CO

**3/4 are indirect physiological effects

Front 8

Describe the mechanism of action for the thyroid hormones.

Back 8

-hormone enters the cell and binds to specific receptors in the nucleus
-act as transcription factors leading to altered protein production in cell

Front 9

What are causes for hyperthyroidism?

Back 9

thyroid tumors
abnormal regulation of thyroid secretion (Graves Disease)

Front 10

Describe signs and symptoms one might see in a patient with hyperthyroidism.

Back 10

- goiter (enlarged thryoid)
- muscle wasting
- metabolic changes (weight loss with increased appetite
- tachycardia

Front 11

Name 4 types of drugs that are used to treat hyperthyroidism.

Back 11

1, antithyroid agents -- directly inhibit thyroid hormone snythesis
2. iodide -- short term
3. radioactive iodine -- tissue desctruction, selective
4. Beta-adrenergic blockers -- changes affects of thyroid hormone production

Front 12

What are adversed affects of drugs used to treat hyperthyroidism caused by?

Back 12

problems come from overdosing

Front 13

Name the causes of hypothyroidism.

Back 13

idiopathic
autoimmune (hashiomoto thyroiditis)
congential
low iodine intake
genetic

Front 14

What are signs and symptoms we might see with a patient who has hypothyroidism?

Back 14

-goiter possibly
-lethargy, slow thought processing
-metabolic changes (weight gain, decreased appetite -- too much glucose being stored and not pulled into blood stream)
-bradycardia

Front 15

What types of drugs are used to treat hypothyroidism?

Back 15

thyroid hormone replacement treatment
- can be synthetic or natural
- may contain T3 or T4

Adverse Effects: due to overdose

Front 16

1. What is the function of the parathyroid glands?

2. What is Ca++ important for?

Back 16

1. control Ca++ homeostasis

2.skeletal muscle, heart, nerve function

Front 17

What hormone do the parathyroid glands synthesize? What is its function?

Back 17

parathyroid hormone (PTH) -- increase plasma Ca++ levels

Front 18

Besides PTH (parathyroid hormone) what else regulates Ca++ levels?

How do these 2 substances work?

Back 18

vitamin D and calcitonin

Vitamin D -- enhances bone formation

Calcitonin -- secreted by thyroid, lowers plasma calcium

Front 19

What are indications to using calcium supplements?

Back 19

osteoporosis
rickets
osteomalacia
hypoparathyroidism

Front 20

What is the function of calcium supplements?

Back 20

addition Ca++ source to encourage bone formation

Front 21

What are some possible adverse affects of calcium supplements?

Back 21

hypercalcemia -- leads to arrhythmias, HTN, mental disturbances

Front 22

What is an indication to taking vitamin D?

Back 22

vitamin-D deficiency related disorders (rickets, osteomalacia), used with calcium supplements

Front 23

What is Vitamin D's function?

Back 23

enhances bone formation by increasing absorption and retention of Ca++ and phosphate

Front 24

What are some adverse effects of Vitamin D?

Back 24

early toxicity -- HA, fatigue,
later -- renal failure, symptoms of hypercalcemia

Front 25

What is rickets? What causes it?

Back 25

childhood form of osteomalacia

(soft bones) due to a vitamin D deficiency

Front 26

What drugs can be used to regulate bone calcification?

Back 26

1. calcium supplements
2. vitamin D
3. biphosphonate (alendronate, Fosamax)
4. Calcitonin
5. estrogen replacement therapy

Front 27

What are indications for taking biphosphonates (alendronate/Fosamax)?

Back 27

pagets disease
osteoporosis
offset changes due to long-term glucocorticoid use

Front 28

What is the function of biphosphonates (alendronate, Fosamax)?

Back 28

normalize bone turnover, blocks bone reabsorption

** must maintain upright for 30 minutes afterwards

Front 29

What are adverse effects of taking biphosphonates?

Back 29

GI disturbances
esophagitis

Front 30

What are indications for taking calcitonin?

Back 30

hypercalcemia, pagets disease, vertebral fracture, to prevent bone loss in other diseases

Front 31

What is Calcitonin's function?

Back 31

mimic's endogenous calcitonin and seems to be analgesic for bone pain

Front 32

What are adverse effects experienced after taking Calcitonin?

Back 32

GI disturbances
if injected, irritation at injection site

Front 33

What are secondary effects of estrogen replacement therapy?

Back 33

maintain bone mineralization

Front 34

What are risks/adverse effects of doing estrogen treatment?

Back 34

CV disease, CA

Front 35

What do we use now for estrogen replacement therapy?

Back 35

SERMs (selective estrogen receptor modulators for osteoporosis prevention

** binds/activates receptors in bone and not to breast/uterine

Front 36

What are the PT indications for someone who's taking drugs that affect bone mineralization?

Back 36

-avoid exacerbations of symptoms of thyroid dysfuction

- beware of changes in Ca++ homeostasis

- treat to help stimulate bone formation (WB)