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39 Cards in this Set
- Front
- Back
What type of receptor does PTH act on? What is increased and it what parts of the body?
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1) G protein coupled receptor
2) increases cAMP in bone and renal tubular cells |
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What is teriparatide? What is it used for?
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1) recombinant truncated PTH
2) osteoporosis |
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How does PTH effect bone in continuous doses vs low intermittent doses?
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1) Continuous = Ca2+ and phosphate resorption increased
2) intermittent = increase bone formation |
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What is the direct effect of vitamin D on bone? What is the indirect effect?
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1) direct = increased calcium and phosphate resorption
2) indirect = promotes bone mineralization by increasing blood levels of calcium and phosphate |
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What is the net effect of PTH on calcium and phosphate levels?
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1) hypercalcemia
2) hypophosphatemia |
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What is the net effect of vitamin D on serum calcium and phosphate?
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1) hypercalcemia
2) hyperphosphatemia |
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what is the animal form of vitamin D? what is plant form?
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1) cholecalciferol
2) ergocalceferol |
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What inhibits renal vit D synthesis?
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1) increased vit D
2) increased phophates |
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What are topical formulations of vit D used for?
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1) psoriasis
2) hyperproliferative skin disorders |
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doxercalciferol is a prodrug that is also known as?
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1) 1alpha-hydroxyvitamin D2
a. converted in liver to 1,25-dihydroxyvitamin D |
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paricalcitol and calcipotriene are analogs of what?
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calcitriol
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administration of doxercalciferol, paricalcitol and calcipotriene effect the body how?
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1) less hypercalcemia in patients with normal renal function
2) less hypercalciuria than calcitriol Note: these occur because they have shorter half-lives than vit D |
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Calcipotriene is approved for treatment of what?
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topical treatment of psoriasis
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What is the primary toxicity of vitamin D or active metabolites with chronic overdose?
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1) hypercalcemia
2) hyperphosphatemia 3) hypercalciuria |
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What is calcitonins effect on body?
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1) Inhibits Ca2+ absorption by the intestines
2) Inhibits osteoclast activity in bones 3) Inhibits phosphate reabsorption by the kidney tubules 4) Calcitonin increases tubular reabsorption of Ca2+, leading to decreased rates of its loss in urine |
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In what conditions has calcitonin been used?
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1) hypercalcemia
2) Pagets disease 3) osteoporosis |
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what type of calcitonin is prescribed because it has a longer half-life and greater potency than human calcitonin?
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salmon calcitonin
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Which SERM is prescribed for osteoporosis is postmenopausal women?
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raloxifene
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What are examples of bisphosphonates?
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1) alendronate
2) etidronate 3) ibandronate 4) pamidronate 5) risedronate 6) tiludronate 7) zoledronic acid |
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what is the MOA of bisphosphonates?
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1) they are short-chain polyphosphate compounds that reduce bone resorption and formation
2) inhibit osteoclastic activity 3) inhibit farnesyl pyrophosphate synthase needed for osteoclast survival |
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What conditions are bisphosphonates used for?
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1) hypercalcemia of malignancies
2) osteoporosis 3) Pagets disease of bone |
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What are the toxic effects of bisphosphonates?
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1) low dose use for osteoporosis causes GI and esophageal irritation
2) higher dose use for malignancy causes renal impairment and osteonecrosis of the jaw |
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what is the MOA of cinacalect?
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1) lowers PTH by activating calcium sensing receptor in parathyroid gland
2) treats secondary hyperparathyroidism seen in chronic renal disease 3) treats parathyroid carcinoma |
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What are toxicities of cinacalet?
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1) hypocalcemia
2) adynamic bone disease a. profoundly decreased bone cell activity |
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When does acute toxicity of fluoride occur? what are toxic effects?
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1) ingestion of rat poison
2) GI and neurological symptoms |
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What is gallium nitrate used for?
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managing hypercalcemia associated with malignancies and possibly pagets
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What is MOA of gallium nitrate?
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1) inhibits bone resorption
2) nephrotoxic |
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What antibiotics are used for hypercalcemia and Pagets disease of bone?
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1) plicamycin
2) mithramycin Note: used only for short term use because of side effects |
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What are toxic effects of plicamycin?
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1) thrombocytopenia
2) hemorrhage 3) hepatic and renal damage |
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Which diuretics can be used for hypercalcemia?
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1) loop diuretics
Note: thiazides retain Ca2+ so they are contraindicated |
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What is sevelamer?
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1) phosphate binding gel
2) treats hyperphosphatemia a. a complication of renal failure b. hypoparathyroidism c. vitamin D intoxication |
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Names of three bisphosphonates available IV
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Pamidronate, zoledronate, ibandronate
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Major SE of bisphosphonates
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Chemical esophagitis
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Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia
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Etidronate
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Used for prevention of postmenopausal osteoporosis in women
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Estrogen (HRT-Hormone replacement therapy)
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Increase bone density, also being tested for breast CA prophylaxis
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Raloxifene (SERM-selective estrogen receptor modulator)
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Used intranasally and decreases bone resorption
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Calcitonin (salmon prep)
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Used especially in postmenopausal women, dosage should be 1500 mg
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Calcium
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Vitamin given with calcium to ensure proper absorption
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Vitamin D
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