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31 Cards in this Set

  • Front
  • Back
What are the 2 major constituents of Bone?

What are the 2 major regulators of these constituents?
Calcium and Phosphate

Vitamin D - Aids Ca++ absorption
PTH - teriparatide
What is the MOA of PTH in the bone?
Releases RANKL -> increased osteoclast number/activity -> Increases bone turnover
What is the MOA of PTH in the Kidney?
Increases calcium reabsorption
Stimulates vitamin D formation
What is Calcet and what does it do?
Blocks PTH release (antagonist)
Used for hyperparathyroidism
Essentially what does PTH do?
Retards bone loss but doesn't stimulate new growth
What are the PO bisphosphonates?
Allendronate
Risedronate
Etidronate - Inhibits calcification of bone (no osteoporosis)
What is the IV bisphosphonates?
Zolendronate
What are the IV and PO bisphosphonates?
Ibandronate - Most potent form
What is the MOA of Bisphosphonates?
- Analogs of pyrophosphate
- Taken up into bone -> inhibit osteoclast activity
- May also kill osteoclasts
What are the main adverse reactions of the bisphosphonates?
GI disturbance
What must you do in order to take bisphosphonates to try to avoid GI problems?
After a night-long fast
With a large glass of water
While sitting or standing upright

Don't take at same time as C++ Supplement
What is the rare adverse reaction of using bisphosphonates?

What forms are most common in causing this
Jaw Osteonecrosis - Rare (.03-.4%)

IV Forms 94% vs 6% PO
What is the MOA of Denosumab?
Monoclonal Antibody
Antibody against RANKL -> decreased osteoclast formation -> decreased bone turnover
What is the dosage of Denosumab?
1 Injection every 6 months

May take several months to start having an effect
What are the adverse reactions for Denosumab?
Hypocalcemia
Patients must take calcium/vitamin D while on this drug
What are rare adverse reactions to Denosumab?
Increased infections
pancreatitis
What is Gout?
Crystals of Uric Acid in joints (esp. big toe)

Leads to inflammation and pain
What are the treatment strategies for gout?
1)Treat inflammation - some NSAIDS make it worse
2)Increase Uric Acid excretion
3)Block Uric Acid production - Xanthine oxidase inhibitors
What is the MOA of Indomethacin?
Treats inflammation for Gout by COX1 and 2 inhibition
What are the adverse reactions of Indomethacin?
GI upset (most potent), water/sodium retention
Does not decrease uric acid levels

Used for short term relief
What type of anti-inflammatory meds are used for acute forms of gout?
Corticosteroids - NSAIDS
Indomethacin
Colchicine - NSAIDS
What is the MOA of Colchicine
Microtubule inhibitor – blocks cell growth (mitosis)
Kills off immune cells that propagate the inflammatory syndrome
What are the adverse reactions of Colchicine?
GI upset
neutropenia
What are the Uricosuric Agents?
Probenecid
Sulfinpyrazone
What is the MOA of Uricosuric agents?
Block the reabsorption of UA from kidney -> increase excretion of UA
Effects are modest though
If used acutely can precipitate a gout attack - given for mild hyperurecimia
What are the Xanthine Oxidase Inhibitor agents?
Allopurinol
febuxostat
What is the MOA for the Xanthine Oxidase Inhibitors?
Block xanthine oxidase, the rate-limiting step in uric acid synthesis
Febuxostat – much more selective for X2O (long term neg. effects much less)
What are the adverse reactions associated with Xanthine Oxidase Inhibitors?
GI upset
Allopurinol can cause myelosuppression, etc.
_____ itself can lead to issues with jaw bone as can treatment
Osteoporosis
bisphosphonate
_____ and _____ can lead to hypocalcemia which can affect teeth
Cincalcet
denosumab
_____ and _____ can predispose to infection
Allopurinol
colchicine