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pharmacology 14
| Term | Definition |
|---|---|
| Bone mineral density | Test measurement to determine the degree of bone loss. |
| Bone resorption/Osteolysis | Process during which bone is broken down into mineral ions (e.g., calcium) |
| Osteoblasts: | Cells responsible for bone formation, deposit, and mineralization of the collagen matrix of bone |
| Osteoclasts | Cells responsible for bone resorption |
| Osteoporosis | Chronic, progressive disease /loss of bone density and bone strength and resulting in increased risk for fractures. |
| Remodeling | Process of continual turnover of bone/ process of bone formation and loss |
| Low-impact fractures | results from falls/trauma |
| Fragility fractures | absence of trauma/ coughing/sneezing |
| percentage of bone formed greater than percentage of bone lost | <Age 30 or 40 years |
| rates of bone loss for men and women about equal | >Age 65 or 70 years |
| After menopause | bone loss exceeds bone formed |
| Parathyroid hormone | Secretes when absorption of calcium is low Transfers calcium from bone to blood Increases levels of calcium in blood |
| Calcitonin | Stores excess calcium in bone - an Antiresorptive Agents -secreted by the thyroid gland -Used in treatment of Paget’s disease of the bone - Increases bone mineral density (BMD) |
| Vitamin D | Enhances calcium absorption Involved in formation of osteoclasts |
| Paget’s Disease | Progressive disease of bones ⬤ Irregular activity of osteoclasts and osteoblasts ⬤ Cause is unknown ⬤ Genetics, viral infection, and environmental factors are believed to be involved |
| symptoms of Pagents Disease | Excessive bone resorption followed by increased bone formation ⬤ Enlarged, structurally weak bones ⬤ Bowed legs ⬤ Constant or intermittent pain ⬤ Arthritis ⬤ Deafness ⬤ Cranial nerve palsies |
| Antiresorptive drugs | used to treat osteoporsosis and pagents disease Suppress bone turnover and loss Inhibit bone resorption Bisphosphonates Calcitonin |
| Bisphosphonates | a class of antiresorptive drugs used to treat bone diseases like osteoporosis by slowing down bone loss- slow down the action of osteoclasts |
| Anabolic drugs | Promote bone formation A type of hormone replacement therapy drugs Decrease osteoblast cell death |
| Nitrogen-containing bisphosphonates | more potent then non nitrogen |
| side effects of bisphosphonates | Painful swallowing Heartburn Diarrhea Nausea Vomiting |
| what cannnot be taken within 2 hours of bisposphonates ? | No iron, calcium supplements, and antacids |
| Zoledronic acid (Reclast) | may increase risk for renal failure in patients with renal impairment |
| femoral shaft fracture | patients should not take bisposhphates with this |
| Selective Estrogen Receptor Modulators (SERMS) | Treatment and prevention of osteoporosis in postmenopausal women ⬤ Reduces incidence of vertebral fractures |
| Raloxifene | a Selective Estrogen Receptor Modulator (SERMS) used to treat and prevent osteoporosis in post menopausal women |
| Selective Estrogen Receptor Modulators (SERMS) MOA | Bind to estrogen receptors ⬤ Agonist effect in bone and lipid metabolism ⬤ Antagonist effect in breast and uterus |
| Adverse effects of Selective Estrogen Receptor Modulators | Increased risk for venous thromboembolism ⬤ Increased risk for death from stroke |
| Estrogen deficiency | Occurs with onset of menopause Increases osteoclast activity |
| Hormone Replacement Therapy/ Estrogens | Decrease bone turnover, bone loss, and fractures Indicated for prevention rather than treatment Restores estrogen levels/ increases BMD ⬤ Inhibits the effects of estrogen deficiency on cytokines |
| Teriparatide | a powerful anabolic (bone-building) medication used to treat severe osteoporosis in patients at high risk of bone fractures. - limited in use |
| Receptor Activator of Nuclear Factor Kappa-Beta Ligand Inhibitors | drugs or molecules that block the RANKL protein, which is crucial for bone resorption Reverses bone remodeling to formation |
| Denosumab | Binds to RANKL: Receptor Activator of Nuclear Factor Kappa-Beta Ligand Inhibitors Inhibits osteoclast activation Decreases bone resorption Reverses bone remodeling from destruction to bone formation |
| Warning Labels: Denosumab | ⬤ Stand or sit upright for at least 30 minutes after taking dose; do not lie down ⬤ Take 1 hour before first meal of the day ⬤ Take on an empty stomach |
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