Estogen agonist in bone, antagonist in endometrium and breast
Raloxifene
Alendronate, residronate, ibandronate, pamidronate, zoledronate are what class of drugs?
Bisphosphates (antiresorptive drugs)
What step in osteoclast function do bisphosphates block which causes apoptosis?
mevalonate pathway
Used to treat Paget’s disese?
aminobisphosphates
treats hypocalcemia
magnesium cholride
Denosumab is an example of
RANKL antagonist
increases trabecular bone mass while accelerating cortical bone loss
Fluoride
Once a day PTH causes
Increase bone remodeling
continuous exposure of PTH causes
bone catabolism
teriparatide
PTH 1-34 recombinante PTH
What are 3 approaches for preventing secondary hyperparathyroidism in chronic kidney disease?
- Oral phosphate binders
- calcitriol
- Calcimimetics
Precipitates PO4 in GI – treats hyperphosphatemia
alminum hydroxide
binds to dietary PO4 inhibiting its absorption
Calcium carbonate and calcium acetate
nonabsorable Ca ion exchange resin that binds intestinal phosphate and bile acid
Sevelamer
What do active vitamine D congeners by pass?
the need to be 1-alpha-hydroxylated in kidney
1-a hydroxylated form of D2 made active in liver
Doxercalciferol
mechanisms that calcimimetics work by
bind to Ca receptors of cheif cells
Used to treat hypocalcemic states associated with vitamin D dependent rickets and hypoparathyroidism
Calcium gluconate and CaCl
Prevents osteoporosis or treat mild hypocalcemia
calcium citrate, calcium carbonate, calcium phosphate, calcium lctate
What is the preferred method of treating hypoparathyroidism, rickets, etc?
Calcitriol– faster onset and offset, increase intestinal absorption of Ca
What drugs require standing up right for 30 mins after administration?
Bisphosphates
Bisphosphates only avalible in IV
Pamidronate and zoledronate
RANKL antagonist contraindicated in hypocalcemia
denosumab
phosphate binder that Requires acidic pH for absorption
calcium carbonate
