Drugs for Bone & Joint Disorders
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| Parathyroid Hormone(PTH): | Stimulates bone cells, or bone resorption (osteoclasts) which breaks down in order to make calcium available
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| Define bone depositions/bone building | Osteoblasts, which removes calcium from blood to bone by calcitonin
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| Absorption of calcium is increased in the presence of_____ | Vitamin D
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| The inactive form of vitamin D is______, which is synthesized in the skin from cholesterol | Cholecalciferol
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| Cholecalciferol can be obtained from ______ or other foods containing_____ | Milk, vitamin D
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| Cholecalciferol ->Liver-> Kidneys-> Calcitriol | Cholecalciferol ->Liver-> Kidneys-> Calcitriol
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| Hypocalcemia means___? | Low PTH
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| Hypercalcemia means___? | High PTH
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| What is hypocalcemia ? | Too little calcium in the blood due to high PTH
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| Name a hypocalcemia agent. | calcium salts (carbonate lactate, or phosphate )
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| Adverse effects of a hypoglycemia agent. | Hypercalcemia, lethargy, weakness, anorexia, nausea, vomiting, confusion, renal stones, increased urination & dehydration
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| In the blood, calcium occurs in ___ forms. | 3
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| Ionized calcium in the blood is? | About 45% of calcium in our blood, can be freely used by body tissues
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| Complexed calcium in the blood is ? | About 10% of serum calcium which is bonded to bicarbonate, lactate and citrate
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| Bound calcium in the blood is? | About 45% of calcium bound to albumin
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| Metabolic bone disease is caused by? | Abnormal amounts of calcium , phosphate vitamin D or PTH
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| 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
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| What is osteomalacia? | Softening of bones due to demineralization, usually caused by vitamin D and calcium deficiency in the diet
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| What is osteomalacia in a child? | Rickets
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| Bone resorption inhibitor drug class. | calcitriol ( Calcijex, Rocatrol)
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| What are adverse effects of bone resorption inhibitor? | Hypercalcemia, weakness, confusion, anorexia, nausea, vomiting, increased urination, dysrhythmias, dehydration and weight loss
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| Vitamin D drug therapy names. | ergoclaciferol, cholecalciferol,calcitriol
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| 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)
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| What is a biphosphonate? |
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| What is Paget's disease? | Disease that disrupts the replacement of old bone tissue with new bone tissue and bone metasases
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| Name a drug in the biphosphonate class? | alendronate (fosamax)
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| What are adverse effects for Alendronate? | Diarrhea, constipation, flatulence, nausea, vomiting, metallic taste, hypocalcemia, abdominal pain, dyspepsia, headache & rash
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| 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
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| What is a selective estrogen receptor modulators? | Drugs used in prevention & treatment of osteoporosis, may be either estrogen agonists or antagonist
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| What is calcitonin? | Secreted by the thyroid when serum calcium is elevated
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| What is osteoarthritis? | Degenerative joint disease caused by the breakdown of articular cartilage, very common in weight bearing joints (knee, spine, and hips)
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| NSAID's are given to reduce_____? | Pain and inflammation
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| 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
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| Drugs used for Rheumatoid arthritis? | hydroxychloroquine (Plaquenil)
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| What are adverse effects of hydroxychloroquine (Plaquenil)? | Anorexia, GI disturbance, hair loss, headache, mood and mental changes, blurred vision and photophobia
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| What is gout? | acute arthritis cause by accumulation of uric acid crystals in the joints causing inflammation (hypperuricemia)
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| 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
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| Secondary gout? | Caused by diseases or drugs that increase metabolism of nucleic acids (cyclosporine, aspirin, diuretics, alcohol
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| Acute gouty arthritis? | Needle like uric acid crystals accumulate in joints resulting in painful, inflamed tissue
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| Drugs used for Gout? | Allopurinol (Lopurin, Zyloprim)
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| What are adverse effects of Allopurinol (Lopurin, Zyloprim)? | Rash, epidermal necrolysis, Stevens Johnsons syndrome ( a rare, serious disorder of the skin and mucous membranes)
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| 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)
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