Pharmacology Exam 6

Ca²⁺ and P⁺ flux accross cell membranes in bone and kidney resulting in increased serum Ca²⁺ and decreased serum P⁺

• increase activity and number of osteoclasts (indirect effect)
• effect is on osteoblasts

secosteroid made in the skin

increase efficiency of small intestine to absorb dietary calcium and phosphate

hydroxyapatite deposition in bone matrix

• synthetic Vitamin D analog
• regulates absorption of Calcium from the GI tract and utilization in the body

• predialysis patients
• dialysis patients
• hypoparathyroidism patients

hypercalcemia syndrome or Ca²⁺ intoxication

• cholestyramine
• phenytoin/phenobarb
• thiazides
• increases cholesterol

synthetic vitamin D₂ analog that undergoes metabolic activation to 1a25-dihydroxyvitamin D₂

• secondary hyperparathyroidism in pt with chornic kidney disease on dialysis
• secondary hyperparathyroidism in pt with stage 3 or 4 chronic kidney disease

• infection
• chest pain
• constipation

• cholestyramine interferes with absorption
• hypermagnesemia
• CYP450 inhibitors my inhibit activation of Doxercalciferol

• active vitamin D sterols should not be used as initial therapy for nutritional vitamin D deficiency
• Dose titration is usually required

• second generation biphosphate that strengthens bones and prevents bone loss.
• potent inhibitor of bone resorption

• osteoporosis/prophylaxis
• pagets disease

prevents osteolclast activity and bone resoption by binding to Ca2+

• GERD
• esophageal gastritis
• hiatal hernia

• antacids/PPIs
• aspirin

• abdominal pain
• arthralgia
• constipation
• gastritis
• diarrhea

• symptomatic paget's disease
• prophylactic therapy for heterotrophic ossification following hip replacement or spinal injury
• NOT approved for osteoporosis

serum alkaline phosphatase levels

• GI problems
• alopecia
• arthralgia/arthritis
• bone fracture
• esophagitis

nitrogen containing bisphosphonate that inhibits osteoclast mediated bone resorption

• therapy and prevention of osteoporosis in postmenopausal women
• increases bone mineral density
• reduces incidence of vertebral fractures

• severe renal impairment
• creatinine clearance < 30 mL/min

• Diarrhea/abd pain
• arthralgia/myalgia
• ocular inflammation

• extra GI irritation with NSAIDS
• Antacids/PPIs can inhibit absorption

pyridinyl bisphosphonate that inhibits osteoclast mediated bone resorption and modulates bone metabolism

• therapy and prevention of osteoporosis in post menopausal women
• treatement of pagets disease in men and women

• Abd pain
• diarrhea
• gastritis
• back pain
• arthralgia
• bone pain

• hypocalcemia
• renal impairment
• glucocorticoid induced osteoporosis

• inability to sit upright for 30 min
• hypocalcemia
• hypersensitivity

• hypercalcemia of malignancy
• multiple myeloma
• bone metastases from solid tumors in conjuction with standard antineoplastic therapy

• Fever
• nausea
• constipation

• Aminoglycosides (additive Ca²⁺ lowering)
• Loop diuretics (increased risk of hypocalcemia)
• Thalidomide (risk of renal dysfunction in multiple myeloma pt)