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Ch 48

Drugs for Bone & Joint Disorders

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