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bone disorders-

pharm

QuestionAnswer
What are some vitamin D metabolites? cholecalciferol, ergocalciferol, calcitriol, doxercalciferol,paricalcitol, calcipotriene
MOA of vitamin D metabolites Regulate gene transcription via the vitamin D receptor stimulating intestinal calcium absorption, bone resorption, renal calcium and phosphate reaborption-decrease pth-promote innate immunity-inhibit adaptive immunity
vitamin d metabolites toxicities hypercalcemia, hypercalciuria-the vitamin d preparations have much longer half-life than teh metabolites and analogs
osteoblasts cells responsible for anabolic activity of bone
osteoclasts cells responsible for catabolic activity of bone
what is the active metabolite of vitamin d 1,25 dihydroxyvitamin D
once released, pth maintains a constant concentration of ionic calcium in the extracellular fluid by several processes: 1. enhanced intestinal absorption of ca and phos 2. enhanced rate of resorption of ca and phos from the bone 3. increased tubular reabsorption of ca with inhibition of tubular reabsorption of phosphate in the kidney
Major androgen by quantity DHEA
FSH in males stimulates -----to produce -----thereby stimulating spermatogenesis sertoli cells,,,,androgen binding protein
FSH also stimulates--- cells to produce ----- which provides neg. feedback to the ant. pituitary to decrease FSH secretion. Sertoli cells....inhibin
LH in men stimulates ---cells to produce---- leyig cells....testosterone
in women what is the major plasma androgen androstendione--in women androsteindion is teh major plasma androgen and is secreted in teh blood stream or converted into either Testosterone or estradiol by te ovary.
because testosterone undergoes extenstive first pass metabolism you should not normally do wat give terestorone enterally
Leuprolide GnR analog to suppress gonadal function. SC adminitration to treat prostate canncer.
Adverse effect of ketoconazole in men gynecomastia
finasteride moa 5 alpa reductase inhibition/clinical use- benign prostatic hyperplasia /effective in reducing prostate size in men ; treat women with hirstuism
cyproterone antiandrogen that inibit action of androgen at target organ. acetate form has progestational effect that suppresses feedback enhancement of fsh/lh increasing antiandrogen effect-used with estrogen to treat hirstuism, treat excessive sex drive in women
flutamide potent antiandrogen, tx prostate cancer, not a steroid, acts like a competitive antagonist at teh androgen receptor. can cause mild gynecomastia. adv effects; mild reversible hepatic toxicity.
Bicalutamid potent oral antiandrogen adminstered in sinle daily dose. treats prostate caner.
spironolactone competitive inhibitor of aldosterone. competes with dihydroT for androgen receptors in target tissues /lowers plasma levesl of t
gossypol cottonseed derivative MOA: destroys seminiferous epithelium bud does not alter endocrien function of testis. effect-hypokalemia, may lead to transient paralysis.
What are some biphosphonates Ibimdronate, Pamidronate, Alendronate, Risedronate,Zoledronate
MOA bisphosphates Decrease osteoclast mediated Ca resorption
what is the most abundant mineral in the body and essential for bone teeth, and muscle, nerve development? CALCIUM
3 processes that pth maintains a constant ca 1. enhance intestinal absorption of ca/phos 2. enhanced rate of abosprtion of ca/phos from bone 3.increased tubular reabsopriton of ca with inhibition of tubular reabsoprtion of phosphat in the kidney
vitamin d metabolit formed in the liver and major circulating form of the vitamin calcifidiol
the primary active metabolite of vit d3 calcitriol (1,25 dihydroxyvitamin d)
ergocalciferol plant hormone with similar biologic acitivty
which enzyme is responsible for the final conversion of 1,25 ohd 25 hydroxy chole calciferol 1 hydroxylase
remodeling balance the coupling of bone resorption and formation
collagenous substance released by osteoblast osteoid
major causes of hypercalcemia hyperparathyroidism and cancer
goal for hypercalcemia treatment lowering serum ca concentration and correcting or decreasing the underlying disease
5 approaches for correcting hypercalcemia 1.increase urinary excretion 2.diminished bone resorption 3. decreased intestinal ca absorption 4. chelation of ionized ca 5. dialysis
how do you increase ca excretion by inhibiting proximal and loop sodium reabsorption thereby reducing the passive reabsorption of ca
3 classes of drugs that lower serum ca concentration biphosphonates, calcitonin, gallium nitrate and plicamycin or mithramycin but its obsolete
calcitonin is secreted by what cells parafollicular C cells of thyroid gland
salmon calcitonin is used therapeutically in part because it is cleared more slowly from the circulation-high affinity for human calcitonin receptors
malignancy related hypercalcemia zoledronic acid (zometa) iv za is the biphosphonate of choice for malignancy associated hpercalcemia because it is more potent than pamidronate, and can be administered over a shorter period of time
treatment for postmenopausal osteoporosis and glucocorticoid induced osteoporosis alendronate
pamidronate used to treat pagets, mm, hypercalcemia
drug of choice for hypoglycemia iv ca gluconate
causes of hyperphosphatemia massive acute phoshpate load chronic renal failure primary increase in proximal phosphate reabsorption
Created by: emorgan03
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