MSK AND ENDOCRINE DRUGS | GUARANTEED SUCCESS
STARTS HERE! LEARN, PRACTICE & EXCEL!
Calcitriol and dose Answer: Vit D supplement, decease bone reabsorption
15mcg/day
calcium supplementation dose Answer: 1200 mg/day
ADRs of vit. D or calcium suplements Answer: hypercalcemia
estrogen replacement therapy (HRT) Answer: estrogen inhibits osteoclasts
decreases bone reabsorption to treat osteoporosis
not first line because of cancer risk, short term
Raloxifene (evista) Answer: Selective Estrogen Receptor Modulator (SERM)
binds to estrogen receptors on bones
selective for bones, blocks estrogen receptors in the utereus and breast (protecting against
cancer)
ADRs of Raloxifene (Evista) Answer: thromboembolic events, black box warning related to DVT
and PE
calcitonin salmon Answer: hormone secreted by thyroid
less effective treatment for osteoporosis than other agents
Teriparatide (Forteo) Answer: only drug that promotes bone formation
form of human PTH:
1. increases serum calcium via osteoclasts
2. increases calcium reabsorption in glomerulus
*** increases activation of vit. D, leading to bone deposition by osteoblasts
(build a fort)
teriparatide (forteo) route of administration Answer: SQ only, given daily
prefilled pen injector
other routes shown to worsen osteoporosis
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, ADRs of teriparatide (forteo) Answer: black box warning for osteosarcoma, seen in animals
back pan, leg cramps
orthostatic hypotension
-dronates Answer: biphosphonate
most common treatment for osteoporosis
block bone reabsorption by decreasing osteoclast activity
(drones shooting down osteoclasts)
-dronates indication Answer: prevention and treatment of osteoporosis
-dronates considerations Answer: poorly absorbed (very low bioavailability, around 0.7%)
need to be taken on an empty stomach with water only
remain in bones and effective for decades
ADRs of -dronates Answer: esophagitis/esophageal ulcer
need to take with a lot of water and fully upright to allow to pass fully through
wait 30 min minutes before consuming anything other than water after taking
(do remember or neck)
biphopshates ROA Answer: oral or IV
daily, weekly, bi-weekly, monthly
Denosumab (Prolia, Xgeva) Answer: monoclonal antibody, decreases formation and function of
osteoclasts
MAB = Monoclonal AntiBody
Denosumab ROA Answer: sub Q, every month
ADRs if denosumab Answer: back pain
hypocalcemia
serious infections
dermatologic rxns (dermatitis, eczema)
osteonecrosis of the jaw
(dinos with skin conditions, infections, back pain, cant chomp)
treatments of rheumatoid arthritis Answer: NSAIDs, Gluccocorticoids, DMARDS
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
STARTS HERE! LEARN, PRACTICE & EXCEL!
Calcitriol and dose Answer: Vit D supplement, decease bone reabsorption
15mcg/day
calcium supplementation dose Answer: 1200 mg/day
ADRs of vit. D or calcium suplements Answer: hypercalcemia
estrogen replacement therapy (HRT) Answer: estrogen inhibits osteoclasts
decreases bone reabsorption to treat osteoporosis
not first line because of cancer risk, short term
Raloxifene (evista) Answer: Selective Estrogen Receptor Modulator (SERM)
binds to estrogen receptors on bones
selective for bones, blocks estrogen receptors in the utereus and breast (protecting against
cancer)
ADRs of Raloxifene (Evista) Answer: thromboembolic events, black box warning related to DVT
and PE
calcitonin salmon Answer: hormone secreted by thyroid
less effective treatment for osteoporosis than other agents
Teriparatide (Forteo) Answer: only drug that promotes bone formation
form of human PTH:
1. increases serum calcium via osteoclasts
2. increases calcium reabsorption in glomerulus
*** increases activation of vit. D, leading to bone deposition by osteoblasts
(build a fort)
teriparatide (forteo) route of administration Answer: SQ only, given daily
prefilled pen injector
other routes shown to worsen osteoporosis
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, ADRs of teriparatide (forteo) Answer: black box warning for osteosarcoma, seen in animals
back pan, leg cramps
orthostatic hypotension
-dronates Answer: biphosphonate
most common treatment for osteoporosis
block bone reabsorption by decreasing osteoclast activity
(drones shooting down osteoclasts)
-dronates indication Answer: prevention and treatment of osteoporosis
-dronates considerations Answer: poorly absorbed (very low bioavailability, around 0.7%)
need to be taken on an empty stomach with water only
remain in bones and effective for decades
ADRs of -dronates Answer: esophagitis/esophageal ulcer
need to take with a lot of water and fully upright to allow to pass fully through
wait 30 min minutes before consuming anything other than water after taking
(do remember or neck)
biphopshates ROA Answer: oral or IV
daily, weekly, bi-weekly, monthly
Denosumab (Prolia, Xgeva) Answer: monoclonal antibody, decreases formation and function of
osteoclasts
MAB = Monoclonal AntiBody
Denosumab ROA Answer: sub Q, every month
ADRs if denosumab Answer: back pain
hypocalcemia
serious infections
dermatologic rxns (dermatitis, eczema)
osteonecrosis of the jaw
(dinos with skin conditions, infections, back pain, cant chomp)
treatments of rheumatoid arthritis Answer: NSAIDs, Gluccocorticoids, DMARDS
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
