"dronates" are Bisphosphonates, commonly used to prevent/treat osteoporosis. Most common adverse effects are Esophagitis (patients should take with water and be upright for at least 30minutes), Osteonecrosis of the jaw, and atypical femoral stress fractures. -taken right from FA 2018 pg 471

pharm causes of pill-induced esophagitis = bisphosphonates, tetracyclines, NSAIDs, iron, potassium chloride

bisphosphonates MOA = bind hydroxapatite to reduce osteoclast activity (used in osteoporosis, Paget disease of bone, osteogenesis imperfecta, hypercalcemia and mets to bone)

osteoporosis pharm

1. Ca2+/Vit D supplementation (prophylaxis)

2. bisphosphonates - ADMEs = esophagitis, ONJ, atypical femoral stress fractures

3. pulsatile PTH analogs (teriparatide) = only one that incr bone growth (stimulates osteoblasts) --> transient hypercalcemia, also incr risk of osteosarcoma (dont give to paget dz of bone or any cancer pt)

4. SERM (raloxifene = antagonist at breasts and uterus, AGONIST at bone = no incr risk of endometrial hyperplasia...but still incr risk of thromboembolism)

5. denosumab (mab against RANKL i.e. mimics OPG)

6. rarely calcitonin

pharm causes of pill-induced esophagitis = bisphosphonates, tetracyclines, NSAIDs, iron, potassium chloride

bisphosphonates MOA = bind hydroxapatite to reduce osteoclast activity (used in osteoporosis, Paget disease of bone, osteogenesis imperfecta, hypercalcemia and mets to bone)

osteoporosis pharm - Ca2+/Vit D supplementation (prophylaxis) - bisphosphonates - pulsatile PTH analogs (teriparatide) = only one that incr bone growth (stimulates osteoblasts) --> transient hypercalcemia, also incr risk of osteosarcoma (dont give to paget dz of bone or any cancer pt) - SERM (raloxifene = antagonist at breasts and uterus, AGONIST at bone = no incr risk of endometrial hyperplasia...but still incr risk of thromboembolism) - denosumab (mab against RANKL i.e. mimics OPG) - rarely calcitonin

pharm causes of pill-induced esophagitis = bisphosphonates, tetracyclines, NSAIDs, iron, potassium chloride

bisphosphonates MOA = bind hydroxapatite to reduce osteoclast activity (used in osteoporosis, Paget disease of bone, osteogenesis imperfecta, hypercalcemia and mets to bone)

osteoporosis pharm

1. Ca2+/Vit D supplementation (prophylaxis)

2. bisphosphonates - pulsatile PTH analogs (teriparatide) = only one that incr bone growth (stimulates osteoblasts) --> transient hypercalcemia, also incr risk of osteosarcoma (dont give to paget dz of bone or any cancer pt)

3. SERM (raloxifene = antagonist at breasts and uterus, AGONIST at bone = no incr risk of endometrial hyperplasia...but still incr risk of thromboembolism)
4. denosumab (mab against RANKL i.e. mimics OPG) - rarely calcitonin

pharm causes of pill-induced esophagitis = bisphosphonates, tetracyclines, NSAIDs, iron, potassium chloride

bisphosphonates MOA = bind hydroxapatite to reduce osteoclast activity (used in osteoporosis, Paget disease of bone, osteogenesis imperfecta, hypercalcemia and mets to bone)

osteoporosis pharm 1. Ca2+/Vit D supplementation (prophylaxis) 2. bisphosphonates - pulsatile PTH analogs (teriparatide) = only one that incr bone growth (stimulates osteoblasts) --> transient hypercalcemia, also incr risk of osteosarcoma (dont give to paget dz of bone or any cancer pt) 3. SERM (raloxifene = antagonist at breasts and uterus, AGONIST at bone = no incr risk of endometrial hyperplasia...but still incr risk of thromboembolism) 4. denosumab (mab against RANKL i.e. mimics OPG) - rarely calcitonin