Term
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Definition
Class: bone drug, bone anti-catabolic, bisphophonate
Mechanism: inhibit osteoclast fx by perturbing mevalonate pathway of cholesterol synthesis, inhibition blocks bone resorption and decreases plasma calcium
Indications: osteoporosis (tx and prevent, postmenopausal, men and glucocorticoid-induced), Paget's disease, heterotopic ossification after hip replacement or spinal injury, hypercalcemia 2* to malignancy
Contraindications: esophageal abnormalities (potential for erosion), hypocalcemia
Drug interactions: calcium, antacids, oral meds w/ divalen cations interfere with this med absorption
Adverse effects: high doses inhibition formation and growth of bone --> atypical femur fractures, osteonecrosis of jaw, esophageal cancer, gastric irritation
Pharmacokinetics:
Absorption - oral or IV |
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Term
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Definition
Class: bone drug, anti-catabolic
Mechanism: inhbit osteoclast function by disrupting mevalonate pathway of cholesterol synthesis, inhibition blocks bone resorption and reduces plasma calcium
Indications: osteoporosis (tx and prevention, postmenopausal, men, glucocorticoid-induced)
Contraindications: esophageal abnormalities, hypocalcemia
Drug interactions: absorption decreased by calcium/antacids/oral meds w/ divalent cations
Adverse effects: high doses --> inhibit bone formation and growth --> atypical femur fractures, osteonecrosis of jaw, esophageal cancer; GI upset
Pharmacokinetics:
Absorption - oral or IV |
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Term
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Definition
Class: bone drug, anti-catabolic, SERM
Mechanism: inhibit bone resorption, suppress PTH-induced bone resoprtion, suppress osteoclast activity/survival, increase lifespane of osteoblast and osteocytes, antagonist in breast and endometrium
Indications: osteoporosis (tx and prevent in postmenopause, WOMEN W/ BREAST CANCER OR HX OF)
Contraindications: active or past history of venous thromboembolism, pregnancy/breast feeding
Adverse effects: hot flashes, thomboembolism
Absorption: oral |
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Term
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Definition
Class: bone drugs, bone anti-catabolic
Mechanism: inhibit osteoclast fx, decrease bone resorption, decrease tubular reabsorption, increase excretion of calcium and phosphate
Indications: postmenopausal osteoporosis (>5yrs postmenopause), Paget's disease, hypercalcemia
Contraindications: allergy to salmon
Adverse effects: rhinitis, injection site inflammatory rxn, hypocalcemia
Admin: nasal spary or subq/IM injection |
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Term
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Definition
Class: bone drug, bone anabolic
Mechanism: recombinant PTH, agonist, stimulate osteoblast over osteoclasts, stimulates new bone formation and increase bone mineral density
Indication: severe osteoporosis
Contraindications: OSTEOSARCOMA or high risk of
Adverse effects: hypercalcemia, hypercalciuria, increased risk of osteosarcoma |
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Term
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Definition
Class: bone drugs
Mechanism: Vitamin D analog, increase absorption of dietary calcium, increase bone resorption to increase plasma calcium and phosphate, decrease PTH release
Indications: 2* hyperparathyroidism (mild-mod kidney disease), hypocalcemia in post-surgical/idiopathic/pseudo-hypoparathyroidism, hypocalcemia in pt on dialysis, psoriasis
Contraindications: hypercalcemia, hyperphosphatemia, evidence of vitamin D toxicity
Adverse effects: hypercalcemia, hyperphosphatemia, hypercalciuria |
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Term
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Definition
Class: bone drug, antihypercalcemic therapy
Mechanism: activates calcium-sensing receptor on surface of chief cells, decreases secretion of PTH
Indications: 2* hyperparathyroidism with severe chronic kideny disease and dialysis; hypercalcemia in pt with parathyroid carcinoma
Contraindications: hypocalcemia
Adverse effects: hypocalcemia (prolonged QT, arrhythmia, adynamic bone disease), nausea
Admin: oral |
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Term
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Definition
Class: bone drug, antihypocalcemic therapy
Mechanism: increases plasma calcium levels and then decreases PTH secretion
Indication: hypocalcemia 2* to hypoparathyroidism, hypocalcemia 2* to rapid growth or pregnancy, adjunct for Rickets or osteomalacia, dietary calcium deficiency
Contraindications: pt w/ ventricular fibrillation or hypercalcemia
Adverse effects: nausea, constipation, stomach upset
Admin: IV or oral |
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