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Flashcards in Endocrine drugs Deck (135)
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1
Q

Drug that is purified from the urine of postmenopausal women and is used to promote spermatogenesis

A

Urofollitropin

2
Q

A 3 year old boy with failure to thrive and metabolic disturbance was found to have an inactivating mutation in the gene that encodes the growth hormone receptor. Which drug will most likely improve his metabolic function and promote its growth

A

Mecasermin

  • a combiantion of recombinant IGF-1 and the binding protein that protects IGF-1 from immediate destruction
3
Q

An important difference between leuprolide and ganirelix is that ganirelix _____

A

immediately reduces gonadotropin secretion

  • Leuprolide
    • agonist of GnRH receptors
    • about 1 week of sustained activity
  • Ganirelix
    • GnRH antagonist
4
Q

used to treat the amenorrhea-galctorrhea syndrome

A

Bromocriptine

  • dopamine receptor agonist
    • drug should not be used in patients with a history of schizophrenia or other forms of psychotic illness
5
Q

Patient is a known case of turner syndrome. Which drug will allow her to achive a higher adult height

A

Somatropin

  • recombinant human GH
    • Turner syndrome or chronic renal failure
  • ACTH
    • used in diagnosisng adrenal insuffciency
  • CRH
    • distringuish cushing’s syndrome from ectopic ACTH secretion
6
Q

Most appropriate drug to treat precocius puberty

A

Leuprolide

  • GnRH agonist
7
Q

Pharmacologic treatment for acromegaly

A

Octreotide

  • somatostatin analog. has some efficacy in reducing the excess GH production
8
Q

The 2nd step in ovulation induction is the administration of a drug with FSH activity.

A

Follitropin

  • Recombinant FSH
  • hCG - LH analog
9
Q

treatment for pituitary diabetes insipidus

A

Desmopressin

  • V2 receptor
10
Q

Somatropin

A

Recombinant human GH. Actis through GH receptors to icnrease the production of IGF-1

Replacement in GH deficienct. Icnreased final adult height in children with certain conditions associated with short stature. Wasting in HIV infection. Short bowel syndrome

SQ injection

SE: In children, pseudotumor cerebri, slipped capital femoral epiphysis, progression of scoliosis, edema ,and hyperglycemia. In Adults, peripheral edema, myalgia,and arthralgias. Risk os asphyxia in severely obese patients with Prader Willi syndrome and upper airway obstruction or sleep apnea

11
Q

Mecasermin

A

IGF-1 agonist

Replacement of IGF-1 deficiency that is not responsive to exogenous GH
SQ injection

SE: hypoglycemia, intracranial hypertension, increased liver enzymes

12
Q

Octreotide

Lantreotide: long acting formulation for Acromegaly

A

Somatostanin receptor agonist

Used in Acromegaly an several other homone secreting tumors. Acute control of bleeding from esophageal varices

SC or IV injection. Long acting formualtion injected IM

SE: GI disturbances, galsstone, bradycardia, cardiac conduction anomalies

13
Q

Pegvisomant

A

Blocks GH receptor signalling

USed in acromegaly

SC injection

Increased liver enzymes

14
Q

Follitropin alfa

A

FSH receptor agonist

Used in controlled ovulation hyperstimualtion in women. Infertility due to hypogonadotropic hypogonadism in men

SC injection

SE: ovarian hyperstimulation syndrome and multiple pregnancies in women. Gynecomastia in men. Headache, depression, edema, in both sexe

15
Q

Recombinant product with the same peptide sequence as follitropin alfa but differs in its carbohydrate side chains

A

Follitropin beta

16
Q

Human FSH purified from the urine of postmenopausal women

A

Urofollitropin

17
Q

Extract of the urine of postmenopausal women; contains both FSH and LH activity

A

Menotropins (hMG)

18
Q

hCG

A

LH receptor agonist

Initiation of final oocyte maturation and ovulation during controlled ovarian stimulation. Male hypogonadotropic hypogonadism

IM or SC injection

SE: ovarian hyperstimualtion syndrome, multiple pregnancies in women. Gynecomastia in men, headache, depression, edema in both sexes

19
Q

Recombinant fom of hCG

A

choriogonadotropin alfa

20
Q

Recombinant form of human LH

A

Lutropin

21
Q

Leuprolide

A

GnRH receptor agonist

Used in ovarian suppresion. Controlled ovarian stimulation. Central precocious puberty in some transgender early pubertal adolescents. Advanced prostate cancer

Adminsitered IV, SC, IM, or intranasally. Depot formulations are available

SE: headache, light headedness, nausea, injection site reactions, with continuous treatment symptoms of hypogonadism

22
Q

Synthetic human GnRH

A

Gonadorelin

23
Q

Ganirelix

A

Antagonist of GnRH receptors

Prevention of premature LH surges during controlled ovarian stimualtion

SC injection

SE: nausea and vomiting

24
Q

GnRH receptor antagonists approved for prostate cancer

A

Degarelix, abarelix

25
Q

Bromocriptine

A

Dopaine D2 receptor agonist

Used in hyperprolactinemia, Parkinson’s disease

Administered orally or for hyperprolactemia, vaginally

SE; GI disturbances, orthostatic hypotention, headache, psychiatric disturbances, vasopasm and pulmonary infiltrates in high doses

26
Q

OXytocin

A

Oxytocin receptor agonist

Used in induction and augmentation of labor. Control of uterine hemorrhage after delivery

IV infusion

SE: fetal distress, placental abruption, uterine rupture, fluid retetion, hypotension

27
Q

Atosiban

A

Antagonist of oxytocin receptor

Tocolysis for preterm labor.

IV infusion

SE: concern about rates of infant death. not FDA approved

28
Q

Desmopressin

A

Agonist of vasopressin V2 receptors

used in pituitary diabetes insipidus. Hemophilia A and vWF

Oral, IV, SC, or intranasal adminsitration

SE: GI disturbances, headache, hyponatremia, allergic reactions

29
Q

Used in treatment of DI and sometimes used to control bleeding from esophageal varices?

A

Vasopressin

30
Q

Conivaptan

A

Antagonist of vasopressin V1a and V2 receptors

used in hyponatremia in hospitalized patients.

Administered as an IV infusion

Infusion site reactions

  • Tolvaptan - silimar but more selective for V2 receptors; oral administration limited to 30 day treatment due to hepatoxicity
31
Q

In grave’s disease, the cause of the hyperthyroidism is the production of an antibody that ___________

A

Activatesthe thyroid gland TSH receptor and stimulates thyroid hormone synthesis and release

32
Q

Methimazole reduces serum concentration of T3 by primarily ____________

A

Preventing the addition of iodine to tyrosine residues on thyroglobulin

33
Q

A rare but serious toxicity associated with the thioamides

A

Agranulocytosis

34
Q

A 56 year old woman presented to the emergency deparment with tachycardia, shortness of breath, and chest pain. She had shortness of breath and diarrhea for the last 2 days and was sweating and anxious. a relative reported that the patient had run out of methimazole 2 weeks earlier. The diagnosisof thyroid storm was made. What drug that is sueful adjuvant in the treatment of thyroid storm?

A

Propanolol

35
Q

What drug can be administered for 10-14 days before surgery to reduce the vasuclarity of the thyroid gland?

A

Lugol’s solution

36
Q

When initiating T4 therapy for an elderly patient with long standing hypothyroidism, it is important to begin with small dosesto avoid ______

A

overstimulating of the heart

37
Q

What hormone is produced in the peripheral tissues when levothyroxine is administered??

A

T3

38
Q

A 62 year old woman presents with complaints of fatigue sluggishness and weight gain. She needs to nap several times. She has been taking T4 for the past 15 years without significant problem regarding her energy level. Her recent history is significant of arrythmia and she is currently taking an anti arrythmic drug. What is the most likely cause of her current situation?

A

Amiodarone

39
Q

A 25 year old woman presents with insomnia and fears she may habe something wrong with her heart. She describes her heart jumping out of her chest. She feel healthy otherwise and reports she has lots of energy. Lab tests confirms hyperthyroidism. What drug that produces permanent reduction activity?

A

131I

40
Q

Thyroid preparations

(Levothyroxine, Liothyronine)

A

Activation of nuclear receptors results in gene expression with RNA formulation and protein synthesis.

Hypothyroidism

MAximum effect seen after 6-8 weeks of therapy. T4 is converted to T3 in target cells, the liver and the kidneys. T3 is 10x more potent than T4

41
Q

Thiomides

(PTU, methimazole)

A

Inhibit thyroid peroxidase reactions, iodine organification and peripheral conversion of T4 to T3

Hyperthyroidism

Oral administration, delayed onset of activity

SE: nausea, GI disturbancs, rash, agranulocytosis, hepatitis (PTU-warning). hypothyroidism

42
Q

Lugol’s solution, potassium iodide

A

Inhibit iodine organification and hormone release. Reduce size and vascularity of thyroid gland

Preparation for surgical thyroidectomy

Oral adminsitration, acute onset of activity within 2-7 days

43
Q

Radioactive Iodine

A

Radiation-induced destruction of thyroid parenchyma

Used in hyperthyroidism. Patient should be euthyroid or on B-blockers before RAI. Avoid in pregnancy and in nursing mothers

Oral adminsitration

SE: sore throat, hypothyroidism

44
Q

Beta blockers

(Propanolol, other beta blcokers lacking partial agonist activity)

A

Inhibition of B receptors; Inhibition of conversion of T4 to T3(propanolol only)

Used in thyroid storm. adjunct to control tachycardia, hypertension, and atrial fibrillation

Rapid onset of activity

SE: asthma, AV blockade, hypotension, bradycardia

45
Q

What is the pharmacologic effect of exogenous glucocorticoids in asthma?

A

Inhibition of leukotriene synthesis

46
Q

One of the adverse metabolic effects of long term glucocorticoid therapy is the ______ of bone, which can result to ________

A

Net loss

Osteoporosis

47
Q

A patient is a known case of cushing’s syndrome due to adrenal tumor. What drug woul be expected to reduce the signs and symptoms of the patient?

A

Ketoconazole

  • Inhibits many types of cytochrome P450
  • reduce the unregulated overproduction of corticosteroids by adrenal tumors
48
Q

Describes the therapeutic effect of glucocorticoid administration in patients with 21a-hydroxylase activity

A

Suppresion of ACTH secretion

49
Q

Describes a glucocorticoid response element

A

A specific nucleotide sequence that is recognized by steroid hormone receptor-hormone complex

50
Q

Gradual tapering of a glucocorticoid is required for recovery of _________

A

The hypothalamic-pituitary-adrenal system

51
Q

Most pont antiinflammatory steroid?

A

Dexamethasone

52
Q

a 54 year old man has developed signs of severe acute adrenal insufficiency. The patient should be treated immediately with this combination

A

Cortisol and fludrocortisone

53
Q

Drug that in high doses blocks the glucocorticoid receptor

A

Mifepristone

  • Competitive antagonist of glucocorticoid and progesterone receptors
54
Q

Prednisone

A

Activation of glucocorticoid receptor alters gene transcription

Used in may inflammatory conditions, organ transplantation, hematologic cancers

Druration of activity is longer than pharmacokinetic half life of drug owing to gene transcription effects

SE: adrenal suppression, growth inhibtion, muscle wasting, osteoporosis, salt retention, glucose intolerance, behavioral changes

55
Q

Fludrocortisone

A

Strong agonist at mineralocorticoid receptors and moderate activation of glucocorticoid receptors

Used in Adrenal insufficiency (Addison’s disease)

Lonh duration of action

SE: salt and fluid retention, congestive heart failure, signs and symptoms of glucocorticoid excess

56
Q

Mifepristone

A

Pharmacologic antagonist of glucocorticoid and progesterone receptors

Used in MEdical abortion, and very rarely Crushing’s syndrome

Oral administration

SE: Vaginal bleeding in women, abdominal pain, GI upset, diarrhea, headcahe

57
Q

Spironolactone

A

Pharmacologic antagonist of mineralocorticoid receptor, weak antagonism or androgen receptors

Used in aldosteronism from any cause, hypokalemia due to other diuretics, post MI

Slow onset and offset of effect. DUration: 24-48h

SE: hyperkalemia, gynecomastia (spironolactone, not eplerenone), additive interaction with other K-retaining drugs

58
Q

Eplerenone

A

More selective for mineralocorticoid receptor

similar to spironolactone

59
Q

Ketoconazole

A

Blocks fungal and mammalian CYP450 enzymes.

Inhibits mammalian steroid hormone synthesis and fungal erogosterol syntesis

Oral, topical administration

SE: hepatic dysfunctio, many drug-dryg CYP450 interactions

60
Q

Beclomethasone and budesonide

A

readily pentrates the airway mucosa but have short half lives after they enter the bloodm so systemic effects and toxicity are greatly reduced

61
Q

A teenager seeks postcoital contraception. What drug will be effective for this purpose?

A

Mifepristone

  • antagonist at progesterone and glucocorticoid receptors
  • has lutelolytic effect
62
Q

A 23 year old woman desires a combine oral contraceptive for pregnancy protection. What patient factor would lead a health professional to recommend alternative form of contraception?

A

History of migraine headache that is well controlled by sumatriptan

  • estrogen containing hormonal contraceptives increases the risk of migraine headcahes
63
Q

Men who uses large doses of anabolic steroids are at increased risk of

A

Cholestatic jaundice and elevation of AST in the blood

64
Q

A 50 year old woman with a positive mammogram undergoes lumpectomy and a small carcinoma is removed. Biochemical analysis of the cancer reveals the presence of estrogen and progesterone receptors. What drug is recommended for the patient?

A

Tamoxifen

65
Q

A 60 year old man is found to have a prostate lump and an elevated prostate specific antigen blood test. MRI suggests several enlarged LN in the lower abdomen. and an xray reveals 2 radiolcuent lesions in the bony pelvis. This patient is likely to be treated with ______

A

Leuprolide

  • GnRH agonist used in the treatment of men with prostate cancer
  • To prevent tumor flares – add flutamide
66
Q

Most appropriate treatment for endometriosis

A

Medroxyprogesterone acetate by intramusculat injection

67
Q

DEWS should never be used in pregnant women because it is associated with _____

A

Infertility and developmenmy of vaginal cancer in female offsprine

68
Q

Unique property of SERMs

A

Act as agonsits in some tissues adn antagonists in other

69
Q

Finasteride has efficacy in the prevention of male-pattern baldness by virtue of its ability to do which of the following?

A

Reduce the production of dihydrotestosterone

  • 5a-reductase inhibitor
70
Q

In patients with a strong family of breast cancer ______ may be a better choice than a full estrogen agonist

A

Raloxifene

71
Q

Ethinyl estradiol

A

Activation of estrogen receptors leads to changes in the rates of transcription of estrogen-regulated genes

USed in hypogonadism in girls, oral and parenteral contraceptive

Oral, parenteral, or transdermal adminsitration. metabolism relies on cytochrome P450 systems. Enterohepatic recirculation occurs

Side Effects:

  • Moderate toxicity
    • Breakthrough bleeding, nasuea, breast tenderness
  • Serious toxicity
    • thromboembolism, gallbladder disease, hyperTG, migrane headache, hypertension, depression
  • In post menopausal women
    • Breast cancer, endometrial hyperplasia(unopposed estrogen)
  • Combination with cytochrome P450 inducer can lead to breakthrough bleeding and reduced contraceptive efficacy
72
Q

Prodrug that is converted ti ethinyl estradiol, contained in some contraceptives

A

Mestranol

73
Q

Long acting estrogens administered IM and used for hypogonadism un young females

A

Estrogen Esters (Estradiol cypionate)

74
Q

Norgestrel

A

Activaion of progesterone receptors leads to changes in the rate of transcription of progeterone-regulated genes

used in parenteral contraception, postcoital contraceptive

Oral, parenteral or transdermal administration, metabolism relies on cytochrome P450. Enterohepatic recirculation occurs

SE: weigh gaine, reversible decrease in bone mineral density (high doses)

75
Q

Drospirenone

A

Spironolactone derivative of norgestrel

76
Q

Tamoxifen

A

Estrogen antagonist actions in breast tissue and CNS. estrogen agonist effects in liver and bone

Used in prevention and adjuvant treatment of hormone-responsice breast cancer

Oral administration

SE: Hot flushes, thromboembolism, endometrial hyperplasia

77
Q

approved for osteoporosis and prevention of breast cancer in selected patients.

Antagonist effect in breast, CNS, and endometrium

Agonist effects in the liver

A

Raloxifene

78
Q

Approved for treatment of menopausal symptoms and prophylaxis of postmenopausal osteoporosis in combiantion with conjugated estrogens

A

Bazedoxifene

79
Q

Partial agonist at estrogen receptor; used for ovulation inductionl antagonis effect in pituitary increases gonadotropin secretion

A

Clomiphene

80
Q

Fulvrestant

A

Estrogen receptor antagonist in ALL tissues

Used in adjuvant treatment of homone-responsive Breast cancer that is resistant to first-line antiestrogen therapy

IM adminsitration

SE: hot flushes, headaches, injection site reactions

81
Q

Anastrozole

A

Reduces estrogen synthesis by inhibiting aromatase enzyme

Used in adjuvant treatment of hormone responsive breast cancer

Oral administration

SE: hot flushes, MSK disorders, reduce bone mineral density

82
Q

Irreversible aromatase inhibitor

A

Exemestane

83
Q

Danazol

A

Weak cytochrome p450 inhibitor and partial agonist of progestin and androgen receptors

Used in endometriosis, fibrocystic breast disease

Oral administration. Drug interactions due to cytochrome P450 inhibition

SE: acne, hirsutism, weigh gain, menstrual disturbance, heaptic dysfunction

84
Q

Mifepristone

A

Progestin and glucocorticoid receptor antagonist

Used in combination with prostaglandin for medical abortion

Oral

SE: GI disturbances (mostly due to misoprostol). vatginal bleeding, atypical infection

85
Q

testosterone

A

Androgen receptor agonist

Used in male hypogonadism. weigh gain in patients with wasting syndromes

Transdermal, buccal, SQ implant

SE: In females, virilization. In men, high doses can cause gynecomastia, testicular shrinkage, infertility

86
Q

Long acting androgens for parenteral administration

A

Testosterone esters (testosterone cypionate)

87
Q

Anabolic steroids

A

Oxandrolone, nandrolone decanoate

Increased ration of anabolic to androgenic activity in laboratory animals. cholestatic jaundice, liver toxicity

88
Q

Finasteride

A

Inhibition of 5a-reductase enzume that converts tetosterone to DHT

USed in BPH, male pattern hair loss

Oral adminisration

SE: rarely, impotence, gynecomastia

89
Q

Flutamide

A

Competitive inhibition of androgen receptor

Usedin advance prostate cancer

Oral

SE: gynecomastia, hot flushes, impotence, hepatotoxicity

90
Q

similar to flutamide but lower risk of hepatotoxicity

A

Bicalutamide, nilutamide

91
Q

Mineralocorticoid receptor antagonist used mainly as potassium sparing diuretic; also gas androgen receptor antagonist, used for the treatment of hirsutism

A

Spironoalctone

92
Q

Ketoconazole

A

inhibition of cytochrome p450 enzymes involved in andrigen synthesis

Ued in advanced prostate cancer that is resistant to first line-antiandrogen drugs

Oral

SE: interferes with synthesis of other steroids. MAny drug interactions due to cytochrome p450 inhibition

93
Q

most likely complication of insulin adminsitration?

A

hypoglycemia

94
Q

Tight control regimen

A

Establish a basal level of insulin with a small amount of along acting preparation (Insulin glargine) and supplemeting the insulin levels, when called for by food intake, with short acting insluin (lispro).

Lest tight control may be achieved with 2 injections of intermediate acting insulin per day.

95
Q

Glipizide is a second generation ___________ that promotes insulin release by closing potassium channels in the pancreatic B cells

A

Sulfonylureas

96
Q

Improtant effect of glucose

A

Increased glucose transport into cells

97
Q

a 54 year old obese patient with type 2 diabetes has a history of alcoholism. In this patient, metformin should either be avoided or used with extreme caution because metformin and ethanol can increase the risk of

A

Lactic acidosis

98
Q

Drug that is taken during the first part of a meal for the purpose of delaying the absorption of dietary carbohydrates?

A

Acarbose

99
Q

The PPAR-y receptors that is activated the TZD increases tissue sensitivoty to insulin by___________

A

Regualting transcription of genese involved in glucose utilization

100
Q

_________ is useful in the treatment of B-blocker induced cardiac depression

A

Glucagon

101
Q

Rapid acting insulin

A

Lispro, aspart, glulisine

102
Q

Intermediate actibg insulin

A

NPH

103
Q

Long acting insulin

A

Detemir, glargine, degludec

104
Q

Metformin

A

Decreased endogenous glucose production

Used in type2 DM

Oral administration

SE: GI distubances, lactic acidosis

105
Q

Glipizide

A

Secretagogues

Increases insulin secretion from pancreatic beta cells by closing ATP sensitive potassium channels

Used in T2DM

Oral

SE: hypoglycemia, weight gain

106
Q

Sulfonylureas with intermediate duration of action

A

Glyburide, glimepiride

107
Q

Fast acting insulin secretatgouges

A

Repaglinide, nateglinide

108
Q

Acarbose

A

Alpha glucosidase inhibitors

used in T2DM

oral

SE: GI disturbances

109
Q

Thiazolidinediones

(Rosiglitazone)

A

Regulatesgene expression by binding to PPAR-y

used in type 2 DM

Oral administration

SE: fluid retention, edema, anemia, weigh gain, bone fracture in women, may worsen heat disease and increase risk of MI

110
Q

Exanatide

A

Analog of glucagon-like peptide-1 (GLP-1) ParenterGLP-1 Receptors

used in T2DM

Parenteral

SE: Gi disturbances, headache, pancreatitis

111
Q

Sitagliptin

A

Inhibitor of the DPP-4 that degrades GLP-1 and other incretins

Used in T2DM

Oral

SE: rhiitis, URTI, Rare allergic reactions

112
Q

Pramlintide

A

Amylin analog

used in T1DM and T2DM

Parenteral adminsitration

SE: GI disturbances, hypoglycemia, headache

113
Q

Glucagon

A

Activates glucagon receptors

Used in severe hypoglycemia and B-blocker overdose

PArenteral administation

SE: Gi disturbances, hypotension

114
Q

SGLT2 inhibitors

(Canaglifozin, dapaglifozin)

A

Inhibit renal glucose absorption via SGLT2

used in T2DM

Oral

SE: Osmotic diuresis, genital and urinary tract infections

115
Q

What drug is routinely added to calcium supplements?

A

Cholecalciferol

116
Q

Most useful for the treatment of hypercalcemia in Paget’s disease

A

Pamindronate

  • Biphosphonates and calcitonin are first line treaments
  • Paminodranate can be given pareneterally
117
Q

The active metabolites of vitamin D act through a nuclear receptor to produce this effect

A

Increase the absorption of calcium from the gastrointestinal tract

118
Q

_________ increases bone formation and bone resoprion

A

Teriparatide

Should not be used longer than 2 years due to risk of osteosarcoma.

119
Q

Long erm therapy 0f ___________ is assocaited with reduction in bone mineral density and an increased risk of fractures

A

Glucocorticoids

120
Q

Oral biphosphontes can cause ___________

A

erosive esophagitis

121
Q

_________ is a peptide hormone that prevents bone resorption. Can be given as nasal spray

A

Calcitonin

(Salmon calcitonin is available as nasal spray)

122
Q

In aptients with chronic kidney disease that requires dialysis, the impaired priduction of active vitamin D metabolities with elevated serum phosphate due to renal impairment leads to secondary hypePTH. Administration of ___________ is necessary

A

Calcitriol

123
Q

_________ is an analog of 1,25 dihydroxyvitamin D3 that lowers serum PTH at doses that rarely precipitate hypercalcemia

A

Paricalcitol

124
Q

MOA of cincalcet as PTH lowering agent

A

Activating the serum sensing receptor in PTH cells

125
Q

Vitamin D metabolites, analogs

(Cholecalciferol, ergocalciferol)

A

Regulates gene transcription via the vitamin D receptor to produce the effect

Used in vitamin D deficiency, osteoporosis, osteomalacia, psoriasis

Oral adminsitration.requires metabolism in the liver or kindey to active forms

SE: hypercalcemia, hyperphosphatemia, hypercalciuria

126
Q

Used for management of secondary hyperPTH in patients with chronic kidney disease and for management of hypercalcemia in patients with hypoPth.

A

Cacitriol

this drug is in its active form

127
Q

an analog of calcitriol approved for psoriasis

A

Calcipotriene

128
Q

Alendronate

A

Suppresses the activity of osteoclasts and inhibits bone resorption

Used in Osteoporosis, Paget’s disease

Oral adminsitration daily or weekly

SE: adynamic bone, esophageal irritation, osteonecrosis of the jaw (rare)

129
Q

Teriparatide

A

PTH analog

Acts throught PTH receptors to produce a netr increase in bone formation

Used in Osteoporosis

SQ inhection

SE: hypercalcemia, hypercaliuria, osteosarcoma in experimental animals

130
Q

full length rhPTH used for hypoPTH

A

Natpara

131
Q

Calcitonin

A

Acts through calcitonin receptors to inhibit bone resorption.

Used in osteoporosis

SQ or intranasal

SE: rhinitis with the nasal spray

132
Q

Raloxifene

A

Estrogen agonist effect in bone. Estrogen antagonist effects in breast and endometrium

Osteoporosis in post menopausal women

Oral adminsitration

SE: Hot flushes, Thromboembolism

133
Q

Denosumab

A

Binds to TANKL an prevents it from stimulating osteoclasts differentiation and function

Used in osteoporosis

SQ every 6 months

SE: may increase risk of infections, osteonecrosis of the jaw (rare)

134
Q

Cinacalcet

A

Actiavates the calcium sensing receptor

Used in hyperparathyroidism

Oral adminsitration

SE: nausea, hypocalcemia, adynamic bone

135
Q

Minerals

(calcium phosphate strontium)

A

Strontium suppresses bone resorption and phosphate required for bone mineralization

Used in osteoporosis, osteomalacia, calcium or phosphate deficiencies

Oral and parenteral

SE: ectopic calcification