Term
Etidronate (Didronel)
Alendronate (Fosamax)
Risedronate (Actonel) |
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Definition
Bisphosphonates, anti-resorptive agents
Deposited in bone where osteoclasts cannot break it down as readily
Inhibit osteoclast recruitment and differentiation from OPCs, inhibit osteoclastic adhesion to bone, shorten osteoclast lifespan by promoting apoptosis
Low oral bioavailability, half-life > 10 years
IV admin can form insoluble aggregates causing renal failure |
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Term
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Definition
Anti-resorptive treatment
Estrogen prevents bone loss during menopause
HRT increased BMD and reduced fractures but breast cancer & CHD were increased |
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Term
Tamoxifen
Toremifene
Raloxifene |
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Definition
Selective estrogen-receptor modulators, anti-resorptive agents
Estrogen receptor agonist in bone & cardiovascular system
Improves bone density in hip and spine, reduced incidence of fractures
Rare side effects include blood clots |
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Term
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Definition
Anabolic agent
PTH causes regulate calcium, Vit D and bone remodelling
Excess of PTH can cause bone loss, small amounts of PTS can increase bone formation
Reduces risk of fractures if followed by antiresorptive agent |
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Term
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Definition
Peptide of PTH, anabolic agent
Approved for treatment of severe osteoporosis or to increase BMD in men
First-line therapy form women 65+ with low BMD and bisphosphonate naive |
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Term
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Definition
Humanized monoclonal antibody that prevents RankL-Rank and inhibits osteoclast formation
Injection under the skin, twice yearly
Reduces the risk of fractures in women, trials are still on-going in men |
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Term
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Definition
Anabolic agent
Injections promote osteoblast activation & ability to form new bone
Injection increases BMD and reduced the risk of fracture
Used for severe & treatment resistant osteoporosis in women and men
Daily sub-cutaneous injection, duration < 2 years |
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Term
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Definition
Anti-resoprtive treatment
32 aa peptide that acts on osteoclasts to inhibit bone resorption
Salmon calcitonin is most widely used & free of side of effects when given intranasally
Direct analgesic effect on bone pain |
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Term
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Definition
Injection under the skin, twice yearly
Reduces the risk of fractures in women, trials are still on-going in men |
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