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INTRODUCTION

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This chapter will be most useful after having a basic understanding of the material in Chapter 44, Agents Affecting Mineral Ion Homeostasis and Bone Turnover in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition contains:

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  • A detailed discussion of the physiology of mineral ion homeostasis

  • A description of the hormonal regulation of calcium and phosphorous homeostasis

  • A discussion of bone physiology

  • A detailed discussion of the pharmacological treatment of disorders of mineral ion homeostasis and bone metabolism, including the therapeutic uses of vitamin D, calcitonin, bisphosphonates, parathyroid hormone (PTH), and calcium sensor mimetics

  • A description of an integrated approach to the prevention and treatment of osteoporosis

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LEARNING OBJECTIVES

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  • Understand calcium and phosphorous homeostasis.

  • Describe the roles of PTH, calcitonin, and vitamin D in calcium homeostasis.

  • Understand the concept of bone resorption and bone formation.

  • Describe the mechanism of action and untoward effects of bisphosphonates.

  • Describe the role of bisphosphonates in the prevention and treatment of osteoporosis.

  • Describe the pharmacological management of hypocalcemia and hypercalcemia.

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DRUGS INCLUDED IN THIS CHAPTER

1α-hydroxycholecalciferol (1-OHD, alphacalcidol, ONE-ALPHA)

22-Oxacalcitrol (1,25-dihydroxy-22-oxavitamin D3, OCT, maxacalcitol, OXAROL)

Alendronate (FOSAMAX)

Calcipotriene (DOVONEX, others)

Calcitonin (CALCIMAR, MIACALCIN)

Calcitriol (1,25-dihydroxycholecalciferol; CALCIJEX, ROCALTROL)

Calcium salts

Cinacalcet (SENSIPAR)

Denosumab (investigational)

Dihydrotachysterol (DHT, ROXANE)

Doxercalciferol (1α-hydroxyvitamin D2, HECTOROL)

Ergocalciferol (calciferol, DRISDOL)

Etidronate sodium (DIDRONEL)

Ibandronate (BONIVA)

Lanthanum carbonate (FOSRENOL)

Pamidronate (AREDIA)

Paricalcitol (1,25-dihydroxy-19-norvitamin D2, ZEMPLAR)

Plicamycin (MITHRACIN)

Risedronate (ACTONEL)

Sevelamer hydrochloride (RENAGEL)

Teriparatide (FORTEO)

Tiludronate (SKELID)

Zoledronate (ZOMETA)

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Table Graphic Jump Location
MECHANISMS OF ACTION OF DRUGS USED IN MINERAL HOMEOSTASIS AND BONE TURNOVER DISORDERS

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