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Final
Lecture 6
65
Anatomy
2nd Grade
12/01/2012

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Term
what are the antiresorptive meds
Definition
bisphosphonates, SERMs, calcitonin
Term
anabolic therapy promotes
waht is the med
Definition
bone formation
teriparatide
Term
for kidney failure what vit d supplment can be used?
why?
Definition
DHT
doesnt need 1a hydroxylation
Term
what is currently not approved as Vit D supplment
Definition
calcitrol
Term
enahnced Vit D clearence/ bad metabolism-> bone sofetning leads to
Definition
rickets
Term
what meds cause Vit d clereance
what disease state?
Definition
pheytoin, phoenoarbital, carbamazapine, rifampin;
hepatic
Term
ADR of DHT-
Definition
hypercalcemia
Term
bisphosphonates are P-C-P analogs of
Definition
pyrophosphate
POP
Term
what are the 2 main bisphosphonates
Definition
alendronate
risedronate
Term
which class of meds are incorporated into the bones
Definition
BPs
Term
1st generation BPS reduce resopriton by increasing _
Definition
osteoclast death
Term
2nd generation(amino) BPs reduce resorption by inhibiting 2 things
Definition
osteoclast funciton and isoprenoid lipid ynth
Term
BPs increase _ and reduce risk of
Definition
BMD
fractures
Term
BPs are polar and high/low absoprtion from GI
Definition
low
Term
BPs are _ excreted
Definition
renally
Term
side effect of BPs
Definition
esophageal distress, naseua
Term
ex of a simple BP
Definition
etidronate
Term
simple BPs form _ antimetabolites
Definition
AppCp
Term
which is mroe potent simple or Nitrogen BPs
Definition
nitrogen
Term
nitrogen BPs inhibit _ synthase
Definition
farnesyl diphosphate
Term
isoprenoid lipids are needed for prenylation of _
Definition
small GTPases-ras, rho, rab
Term
prenylates small GTPases are needed fro
Definition
osteoclast function
Term
what two small GTPases affected by N containing BPs are anti-OP
Definition
Ras, Rab
Term
what GTPase inhibits osteoclast traffic?
which deos apoptosis
Definition
Rab
Ras
Term
med in the SERM class
Definition
raloxifene
Term
raloxifene is estrogen agonist in _
antagonist in _
Definition
bone
breast and endometrial
Term
raloxifene reduces _ type of fractures
Definition
vertebral
Term
raloxifene reduces _ cancer adn doesnt cause _ cancer
Definition
breast
endometrial
Term
SERMs most common side afect
Definition
hot flashes, leg cramps
Term
what SERMs are not approved for OP
Definition
ET, EPT
Term
what med is the recombinant of PTH
Definition
teriparatide
Term
continuous exposure to PTH is bad bc causes
Definition
net bone loss
Term
ADRs of teriparatide
Definition
mausea
leg cramps
Term
what populaitons is terparatide not reccomended
Definition
children or paget's disease
Term
do not use teriparatide in pateints with what disease state
Definition
hypercalcemia
Term
max perriod of use of teriparatide
Definition
2 yrs
Term
what hormones lowers Ca
Definition
calcitonin
Term
where is calcitonin synth
Definition
prarfollical C cells of thyroid
Term
calcitonin works on osteoclasts how-
Definition
binds to receptr, reduces border surface osteoclasts and reduces acticity
Term
calcitonin work on _ to promote Ca excretion
Definition
kidneys
Term
salmon calcitonin is more/less potent, longer lasting than human
Definition
more, longer
Term
side affects of calictonin
Definition
rhinitis , nsal irriation
Term
which med is given intrnasal
Definition
slamon calcitonin
Term
what cells express RANKL
Definition
osteoblasts, t cells,
Term
soluble form of RANKL is formed by 2 ways
Definition
secreted by 2 cells
cleaved from osteoblast
Term
what is the recepotr for RANKL
where is it loacted
Definition
RANK
trnasmembran of osteoclast precursors
Term
RANKL binding produces _
Definition
TRAF-6
Term
TRAF 6 carries signals thru what 2 cascades
Definition
nk kappa b
MAP kinase
Term
what is the natural inhibitor of RANKL
Definition
OPG-osteoprotegerin
Term
what is a human Mab medicaiton agaisnt RANKL
Definition
denosumab
Term
what does denosumab act like
Definition
osteoprotegerin (OPG)
Term
Denosumab is used for _ OP in what population
Definition
severe
post menopausal
Term
MOA of denosumab is 2 things
Definition
reduces resorption
suppresses bone turnover
Term
dosing fro denosumab
how is it admin
Definition
60 mg q 6 months for 3 yrs
subQ
Term
some dise affects of denosumab
Definition
hypocalcemia
eczema
Term
denosumab is contraindicated in - 5
Definition
preggo
hypocalcemia
serious infections
liverr disease
children
Term
what is the transdermal gel med
Definition
testosterone -androgens
Term
androgens see increase BMD in 2 pops
Definition
men with hypogonads
OP women
Term
testosterone contraindicated in men with
Definition
prostate cancer
Term
ADRs of testosterone
Definition
weight gain, acne, testical atrophy
Term
Ca supplements readily availabel where
Definition
pharmacies
Term
absoprtion of Ca increases/decreases with tablet size increase
Definition
decreases
Term
take Ca w/ or w/o meal?
Definition
with
Term
common ADRs of Ca
Definition
constipation, gas, upset stomach
Term
Ca supplment can decrease absorption of - 3 things
Definition
iron
tetracyclines
phenytoin
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