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26 Cards in this Set
- Front
- Back
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What is calcitonin salmon?
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maicalcin - calcitonin analog
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What is etidronate?
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bisphosphate given cyclically for 14 days each month
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What is alendronate?
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bisphosphate available as daily and weekly oral dosing
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What is zoledronate?
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bisphosphate given as IV every 3-6 months
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What is ibadronate?
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bisphosphate available in oral and IV forms
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What is cinacalcet?
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sensitizes calcium sensing receptors in the parathyroid gland to calcium resulting in decreased PTH release and decreased serum calcium
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What is teriparatide?
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PTH analog
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What is the mechanism of action of PTH?
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regulates calcium and phosphate flux across cellular membranes in bone and kidney - increases serum calcium, decreases serum phosphate
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What is the clearance of PTH?
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intact PTH is cleared reapidly by the liver and kidney, half life is minutes
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What is the action of PTH on bone?
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increases activity and numbers of osteoclast INDIRECTLY by directly acting on osteoblasts to produce a protein (RANK) that acts on osteoclasts, increasing bone turnover
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What is the net effect of PTH on bone?
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increased bone resorption
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What is the effect of PTH on bone density?
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increases bone density due to increased bone formation
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What is the action of PTH in the kidney?
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increass ability to resorb calcium and magnesium, reduces ability to reabsorb potassium, aa's, bicarbonate, sodium, chloride and sulfate; stimulates 1,25-dihydroxyvitamin D production
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How is teriparatide administered?
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daily by subcutaneous injection - costs $515/month, can be given for 2 years at most
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What is teriparatide used for?
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reserved for refractory osteoporosis
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What are the side effects of teriparatide?
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nausea, dizziness, leg cramps, headache
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What is cinacalcet used for?
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drug of choice for secondary hyperparathyroidism
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What are the side effects of cinacalcet?
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nausea, vomiting, hypocalcemia, seizures
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What are the interactions with cinacalcet?
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It is metabolized by P450 so anything that induces or suppresses P450
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what is the action of calcitonin?
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inhibits osteoclast bone resorption - DOES NOT INCREASE BONE DENSITY
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what is miacalcin derived from?
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salmon eggs
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what are the side effects of miacalcin?
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nausea, flushing, rhinitis
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what are bisphosphates?
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analogs of pyrophophate that inhibit osteoclast formation = decreased bone resorption
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what is unique about the use of bisphosphates?
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it takes 48 hours to build up in bone to decrease resorption
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what are the side effects of bisphosphates?
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nausea, cramps, diarrhea, jaw osteonecrosis
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what helps prevent the side effects of bisphosphates?
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given in the morning (fasting state) with water while sitting or standing; there are IV forms available if pt can't do that
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