Endocrine Pharmacology: Calcium Homeostasis

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Questions and Answers

What is a side effect of prolonged administration of glucocorticoids in children?

Retarded growth (correct)

Osteonecrosis of the jaw

Breast cancer

Hypocalcemia

What is the mechanism of action of bisphosphonates?

Inhibition of osteoclast apoptosis

Enhancement of calcium absorption

Stimulation of osteoclast apoptosis (correct)

Stimulation of osteoblast activity

What is the recommended administration of bisphosphonates?

On a full stomach with a full glass of water and remaining standing for 30 minutes

On an empty stomach with a full glass of water and remaining standing for 30 minutes (correct)

With food and remaining sitting for 30 minutes

With a full glass of water and lying down for 30 minutes

What is the treatment for hypercalcemia associated with malignancy?

Diuresis with furosemide and hydrocortisone Signup and view all the answers

What is the cause of 90% of cases of hypercalcemia?

Hyperparathyroidism and malignancy Signup and view all the answers

What is the function of estrogen in the treatment of osteoporosis?

To decrease bone resorption Signup and view all the answers

What is the side effect of prolonged use of estrogen in the treatment of osteoporosis?

Breast cancer and endometrial carcinoma Signup and view all the answers

What is the treatment for hypocalcemia?

Calcium gluconate infusion slowly i.v. Signup and view all the answers

What is the therapeutic use of synthetic parathormone (teriparatide)?

Treatment of osteoporosis Signup and view all the answers

What is the effect of calcitonin on serum calcium levels?

Decreases serum calcium levels Signup and view all the answers

What is the mechanism of action of vitamin D?

Increases calcium absorption from the intestine and decreases its excretion by the kidney Signup and view all the answers

What is the site of activation of vitamin D?

Kidney and liver Signup and view all the answers

What is the source of vitamin D2?

Plant sources Signup and view all the answers

What is the side effect of using parathormone for more than 2 years?

Osteosarcoma Signup and view all the answers

What is the effect of calcitonin on bone resorption?

Inhibits bone resorption Signup and view all the answers

What is the therapeutic use of salmon calcitonin?

Treatment of hypercalcemia and osteoporosis Signup and view all the answers

Study Notes

Hormonal Regulators of Ca+2 Metabolism and Bone Mineral Homeostasis

Parathormone (PTH) is a single chain polypeptide secreted by the parathyroid glands.
Synthetic PTH (teriparatide) is used in treatment of osteoporosis, but has a risk of osteosarcoma with long-term use.
PTH increases serum calcium by increasing calcium reabsorption in the kidney, stimulating bone resorption, and stimulating vitamin D activation.
Low intermittent doses of PTH produce an increase in bone formation.
Calcitonin (CT) is a single chain polypeptide secreted by the C-Cells of the thyroid.
Calcitonin decreases serum calcium by decreasing calcium reabsorption in the kidney and inhibiting bone resorption.
Salmon CT is used in treatment of hypercalcemia and osteoporosis.
Vitamin D is a fat-soluble vitamin found in two forms: Vitamin D2 (plants) and Vitamin D3 (animals and human skin).
Vitamin D increases serum calcium by increasing calcium absorption from the intestine and decreasing its excretion by the kidney.
Vitamin D is used in treatment of hypocalcemia, osteoporosis, and rickets.
Glucocorticoids can cause osteoporosis in adults and retarded growth in children due to increased renal Ca2+ excretion and decreased bone formation.
Estrogen decreases bone resorption and is used in treatment of postmenopausal osteoporosis.
Selective estrogen receptor modulators (Raloxifene) stimulate estrogen receptors in bones and block them in the breast and uterus.

Non-Hormonal Regulators of Ca2+ Metabolism and Bone Mineral Homeostasis

Bisphosphonates (Alendronate) inhibit bone resorption by stimulating osteoclast apoptosis.
Bisphosphonates are used in treatment of hypercalcemia associated with malignancy and bone lesions associated with bone metastasis, and treatment of osteoporosis.
Bisphosphonates can cause renal impairment and osteonecrosis of the jaw as side effects.
Thiazide and furosemide are used to treat hypercalcemia by increasing urine flow and enhancing Ca2+ excretion.
Fluoride is used to treat osteoporosis.
Hypercalcemia is caused by hyperparathyroidism or malignancy in 90% of cases.
Treatment of hypercalcemia includes diuresis, hydrocortisone, intravenous bisphosphonates, and hemodialysis.
Hypocalcemia is caused by hypoparathyroidism, chronic renal failure, and vitamin D deficiency, and is treated with a diet rich in calcium and calcium gluconate.

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Description

This quiz covers the regulation of calcium metabolism and bone mineral homeostasis, including hormonal regulators such as parathormone and calcitonin.