Pharm Block 2 (Osteoporosis)

They are Anti-thyroid Drugs, They are Monovalent ions.

They Competitively block the uptake of Iodine

They are not used because they are highlly TOXIC and can cause Aplastic Anemia

They are effective in iodine induced hyperthyroidism.

• Propranolol- manage cardic sympoms of Thyrotoxicosis
• Lithium- Inhibit the sythesis and release of thyroid hormones
• Amiodarone- result in Hypothyroidism

It is an untreated from of hypothyroidism

• Treat with Intravenous T4 (sometimes T3)
• Monitor with plasma TSH levels

• Stable
• Long half life (7 days)
• T4 is converted to T3 so both hormones are produced and available

• Short half life (not used for replacement theropy)
• Greater risk of cariotoxicity (avoid its used in patients with cardiac issues)
• Used for short term suppression of TSH.

It is an acute life threatening stated caused by too much Thyroid hormone release

• - Propronolol (decreases Cardiac sympoms)
• - Propylthiouracil high does (inhibits T4 conversion to T3)
• - potassium Iodide (blocks the release of thyroid hormones)

-increases plasma Ca levels amd decreases plasma phosphate concentration

• Kidney: increased reabsorption of Ca, Decreased of Phosphate.
• Bone: Increases bone reabsorption by stimulating Osteoclasts.HIGH DOSE (low dose it increases bone formation)
• GIT: Increases Ca and Phosphate Absorption by activating Vitamin D (Cacitriol)

It is a recombinant form of PTH that is used for the treatment of osteoporosis in patients that cannot tolerate Bisphosphonates.

Vitamin D is a prohormone

• Vitamin D3 is produced in the Skin from 7 dehydrochlesterol under Ultraviolit light.
• Vitamin D3 is an inactive precursure to the active Calcitriol

To increase the plasma Ca AND phosphate concentrations.

It occures in the Liver at eh 25th position.yeilding 25, hydroxyvitamin D3

This PTH stimulates this to be activated in the KIDNEY at position 1 --> Calcitriol.

• -increase absorption of Both Ca and Phosphate
• -Increase bone formation
• - decrease excretion of both Ca and Phosphate
• - inhibits PTH secretion
• -Increases Phagocytosis, anti-tumor activity and Immunomodulary functions

Treats Osteoporosis, Rickets and Osteomalacia

Used it renal Failure (use Calcitriol because body cannot make its own with the kidney OOC)

these are topical synthetic derivatives of Calcitriol that re used to treat Psoriasis

Note: recall that in treating Psoriasis there is a step wise pattern. Topical>>Photo>>Systemic

• Alendronate (Fosamax)
• Risedronate (Actonel)
• Ibandronate (Boniva)
• Pamidronate (Aredia)
• Zoledronate (Zometa)

• These compounds have P-C-P which is nonhydrolyzable compared to Pyrophosphate P-O-P found in bone hydroxyapatite. Thus they decrease bone loss.
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• They inhibit FPP synthase --> prevents Mevalonate from becomeing Farnesyl PPi which is needed for osteoclasts--> thus decreases Osteoclast activity and decreasing bone reabsorption.

• Osteoporosis
• Pagets disease
• Hypercalcemia of malignancy
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• Esophagitis and GIT distress (note: once taken you cannot lie down and need to drink alot of water)

Estrogens ( inhibiting IL-1 and TNF, thus decrease osteoclasts differentiation)

Raloxifene-selective estrogen receptor modulator

released from the Parafollicular cells in the thyroid fland due to increase of Ca levels

Given via tablet or nasally



Salmon calcitonin (Miacalcin) is 100 times more potent than human calcitonin.

• Principal effects are to lower serum calcium and phosphate
• --inhibits osteoclast activity
• --inhibit the reabsorption of calcium and phosphate from the renal tubules

• Calcitonin (Miacalcin):
• Used in Paget’s disease of bone.
• Postmenopausal osteoporosis.
• Hypercalcemia.

Stimulates new bone formation and renders it more resistnat to reabsorption.

also used in dental caries

-Bisophosphonates, and Raloxifene

-Teriparatide, and Calcitonin