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Ch 48
Drugs for Bone & Joint Disorders
| Question | Answer |
|---|---|
| Parathyroid Hormone(PTH): | Stimulates bone cells, or bone resorption (osteoclasts) which breaks down in order to make calcium available |
| Define bone depositions/bone building | Osteoblasts, which removes calcium from blood to bone by calcitonin |
| Absorption of calcium is increased in the presence of_____ | Vitamin D |
| The inactive form of vitamin D is______, which is synthesized in the skin from cholesterol | Cholecalciferol |
| Cholecalciferol can be obtained from ______ or other foods containing_____ | Milk, vitamin D |
| Cholecalciferol ->Liver-> Kidneys-> Calcitriol | Cholecalciferol ->Liver-> Kidneys-> Calcitriol |
| Hypocalcemia means___? | Low PTH |
| Hypercalcemia means___? | High PTH |
| What is hypocalcemia ? | Too little calcium in the blood due to high PTH |
| Name a hypocalcemia agent. | calcium salts (carbonate lactate, or phosphate ) |
| Adverse effects of a hypoglycemia agent. | Hypercalcemia, lethargy, weakness, anorexia, nausea, vomiting, confusion, renal stones, increased urination & dehydration |
| In the blood, calcium occurs in ___ forms. | 3 |
| Ionized calcium in the blood is? | About 45% of calcium in our blood, can be freely used by body tissues |
| Complexed calcium in the blood is ? | About 10% of serum calcium which is bonded to bicarbonate, lactate and citrate |
| Bound calcium in the blood is? | About 45% of calcium bound to albumin |
| Metabolic bone disease is caused by? | Abnormal amounts of calcium , phosphate vitamin D or PTH |
| Define osteoporosis. | When bone is resorbed at a greater rate than it is deposited, usually common in women over 60 yr, menopause, family history, high alcohol consumption, anorexia, smokers inactive patients, testosterone deficient, low vitamin D or calcium diet |
| What is osteomalacia? | Softening of bones due to demineralization, usually caused by vitamin D and calcium deficiency in the diet |
| What is osteomalacia in a child? | Rickets |
| Bone resorption inhibitor drug class. | calcitriol ( Calcijex, Rocatrol) |
| What are adverse effects of bone resorption inhibitor? | Hypercalcemia, weakness, confusion, anorexia, nausea, vomiting, increased urination, dysrhythmias, dehydration and weight loss |
| Vitamin D drug therapy names. | ergoclaciferol, cholecalciferol,calcitriol |
| Too much consumption of vitamin D is easily possible without signs or symptoms________ | Vitamin D is fat soluble. This will result in hypercalcemia ( vitamin D leaves bones and enters the blood) |
| What is a biphosphonate? | |
| What is Paget's disease? | Disease that disrupts the replacement of old bone tissue with new bone tissue and bone metasases |
| Name a drug in the biphosphonate class? | alendronate (fosamax) |
| What are adverse effects for Alendronate? | Diarrhea, constipation, flatulence, nausea, vomiting, metallic taste, hypocalcemia, abdominal pain, dyspepsia, headache & rash |
| What are adverse effects for raloxifene (Evista)? | Hot flashes, leg cramps, weight gain, fever, depression, insomnia, chest pain, peripheral edema, nausea, vomiting, decreased cholesterol, migraines, breast pain, vaginal bleeding |
| What is a selective estrogen receptor modulators? | Drugs used in prevention & treatment of osteoporosis, may be either estrogen agonists or antagonist |
| What is calcitonin? | Secreted by the thyroid when serum calcium is elevated |
| What is osteoarthritis? | Degenerative joint disease caused by the breakdown of articular cartilage, very common in weight bearing joints (knee, spine, and hips) |
| NSAID's are given to reduce_____? | Pain and inflammation |
| What is rheumatoid arthritis | Chronic disease by disfigurement and inflammation of multiple joints, usually occurring at an earlier age. RA may produce systemic manifestations including infection, pulmonary disease, fatigue, fever etc |
| Drugs used for Rheumatoid arthritis? | hydroxychloroquine (Plaquenil) |
| What are adverse effects of hydroxychloroquine (Plaquenil)? | Anorexia, GI disturbance, hair loss, headache, mood and mental changes, blurred vision and photophobia |
| What is gout? | acute arthritis cause by accumulation of uric acid crystals in the joints causing inflammation (hypperuricemia) |
| Primary gout? | Caused by hereditary defect in uric acid metabolism causing uric acid to be produced faster than it can be expected in the kidneys |
| Secondary gout? | Caused by diseases or drugs that increase metabolism of nucleic acids (cyclosporine, aspirin, diuretics, alcohol |
| Acute gouty arthritis? | Needle like uric acid crystals accumulate in joints resulting in painful, inflamed tissue |
| Drugs used for Gout? | Allopurinol (Lopurin, Zyloprim) |
| What are adverse effects of Allopurinol (Lopurin, Zyloprim)? | Rash, epidermal necrolysis, Stevens Johnsons syndrome ( a rare, serious disorder of the skin and mucous membranes) |
| How to prevent hyperuricemia ? | Use uricosurics- increases excretion of uric acid (probenecid,sulfinpyrazone) inhibit formation of uric acid (allopurinol) Convert uric acid to less toxic form (rasburicase, pegloticase) |
Created by:
alyxinwndrland
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