1. What's the only drug that increases bone formation?
    Teriparatide -- does not try to block bone resorption, as all other osteoporosis drugs do.
  2. What is a synthetic vitamin D2 analong that undergoes metabolic activation in vivo to form active vit D2 that is used to treat secondary hyperparathyroidism associated with chronic renal failure?
  3. What is a synthetic analog of active vitamin D2 that is used to treat secondary hyperparathyroidism associated with chronic renal failure?
  4. Commonly used to prevent and treat osteoporosis, rickets and osteomalacia
    Calcitriol = active vitamin D
  5. What is dihydrotachysterol?
    A synthetic analog of active vitamin D
  6. Name a drug used to treat psoriasis
    Calcipotriol or Calcipotriene = topical derivative of calcitriol
  7. Mechanisms of bisphosphates
    • -- have P-C-P which is nonhydrolyzable compared to Pyrophosphate P-O-P found in
    • bone hydroxyapatite --> P-O-P easily destroyed by osteoclasts
    • -- adsorb to hydroxyapatite and become a part of the bone structure.They are slowly released from the bone during the bone remodeling. Biphosphonates prevent bone resorption by inhibiting
    • osteoclast activity
    • – Prevent attachment of osteoclast to bone.
    • – Decrease the activity of osteoclast .
  8. Uses of bisphosphonates
    • Osteoporosis (even induced by steroids).
    • Paget’s disease of bone.
    • Hypercalcemia of malignancy.
  9. Adverse effects of bisphosphates
    • Esophagitis
    • GIT distress
    • Osteonecrosis of the jaw
  10. Estrogen use in osteoporosis
    Inhibit IL-1 and TNF and thus decrease osteoclasts differentiation/activation
  11. A selective estrogen receptor modulator and its uses
    Raloxifene -- used for prevention/treatment of osteoporosis in women -- decreases osteoclast activity w/o increasing osteoblast activity
  12. When is calitonin secreted? From where?
    Secreted in response to increases in plasma calcium by the parafollicular cells of the thyroid gland
  13. Effects of calcitonin
    • Main effect = to lower serum calcium and phosphate
    • Inhibits osteoclast activity, decreases bone resorption and reduces bone pain
    • Inhibits the reabsorption of calcium and phosphate from the renal tubules
  14. Uses of calcitonin
    • Tx of Paget's disease
    • Postmenopausal osteoporosis
    • Hypercalcemia
  15. Effects of flouride
    • Stimulates new bone formation
    • Increases bone crystal size and renders the bone more resistant to resorption
  16. A monoclonal Ab for Tx of osteoporosis
  17. Mechanism of denosumab
    Binds RANKL on osteoblasts which then prevents osteoblasts from binding RANK on pre-osteoclasts and forming mature osteoclasts -- thereby protects bone from osteoporosis
Card Set
Block 4 May 2011