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30 Cards in this Set

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Who should start therapy according to bone mineral density results
If:
<2 without risk factors
<1.5 with risk factors
What are the effects of PTH?
Activates osteoclast to > Ca+

Increases Ca+ resorption through intestines

Enhances activation of Vit D
What are the effects of Vit D
Increases absorption of Ca+ and phosphate

Decreases excretion of Ca+ through the kidneys
What are the effects of Estrogen?
Decreases the action of PTH in stimulating bone resorption
Name the 3 types of osteoporosis
Type 1: Post menopausal
Type 2: Senile; >70 y/o
Type 3: Drug or Dz induced
What's the gold stardard treatment of osteoporosis
Estrogen replacement theraphy
What are the effects of estrogen
Promotes osteoblast
Prevents resorption
> HDL
< LDL
What are the risks of using estrogen?
Stroke
Bleeding
Breast/Endometrial CA
What are the contraindications of estrogen therapy?
Thromboembolic Dz
Bleedig
Pregnancy
Liver Dz
Breast CA
What estrogen therapies are available?
Conjugated estradiol (Premarin): Use progenstin on the last 12 days of the month in women with an intact uterus

Transdermal estriadol
What are the effects of calcium supplements?
Reduce bone demineralization
What is the dose for calcium supplements?
1000 mg if < 50 y/o
1500 mg if > 50 y/o
What are the S/Sx of hypercalcemia?
Mild:
Constipation
Anorexia
Thirst
N/V

Severe:
Confusion
EKG changes
Delirium
What are the drug interactions of calcium?
Quinolones- binds calcium
Tetracycline
What is the MOA of Calcitonin?
Inhibits osteoclastic bone resorption
What are the formulations of calcitonin?
Human
Salmon
What are the side effects of calcitonin?
Diarrhea
Flushing
Anorexia
Nausea
What is the MOA of Biphosphinates?
Inhibits bone resorption
Name the different biphosphinates
Risedronate
Ibandronate
Pamidronate
Etidronate
Alendronate
T/F biphospinates should be taken on an empty stomach
TRUE: Because they're poorly absorbed
Which biphosphinate causes esophageal ulcers
Alendronate
Which biphosphinate casues hephrotoxicity
Pamindronate
What are the uses of biphosphinates?
Hypercalcemia
Osteoporosis
Paget's Dz
What is the active form of Vit D?
Calcitrol

Used with renal failure patients to control hypocal
What is the MOA of SERM?
Selective Estrogen Receptor Modulator
Estrogen agonist effects in bone and lipid metabolism

Antagonist in breast and uterine tissue
What is the MOA of Evista?
< bone resorption
No estrogen-like effects
No change in HDL
< LDL and total cholesterol
What are the uses of Evista?
As alternative for women who can't take HRT
What are the side effects of Evista?
Chest pain
Vaginal bleed
Hot flashes
What are the contraindications of Evista?
Pregnancy
Thrombolic events
What is the injectable human PTH called?
Forteo

Use with people who have high risk of fractures