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Paper II — 2014 September (Supplementary) (2010 Scheme) — Q3

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Paper II
2014 September (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Bisphosphonates

Q33 marksShort Notes

Answer

Bisphosphonates are drugs used for bone disorders characterized by excessive osteoclastic activity.

Examples

  • Alendronate, Risedronate, Zoledronic acid, Pamidronate

Mechanism of action

  • Bind avidly to hydroxyapatite in bone, concentrating at sites of active bone resorption
  • Taken up by osteoclasts, they inhibit the enzyme farnesyl pyrophosphate synthase (nitrogen-containing bisphosphonates), disrupting osteoclast cytoskeleton and function, and promoting osteoclast apoptosis — reducing bone resorption

Uses

  • Osteoporosis (postmenopausal, glucocorticoid-induced)
  • Paget’s disease of bone
  • Hypercalcaemia of malignancy
  • Bone metastases (reduces skeletal complications)

Adverse effects

  • Oesophagitis/oesophageal ulceration (oral bisphosphonates — must be taken with water, sitting upright)
  • Osteonecrosis of the jaw (rare, especially with IV use)
  • Atypical femoral fractures with long-term use
  • Acute phase reaction (fever, myalgia) with IV bisphosphonates
  • Hypocalcaemia
  1. 1Drugs for Disorders of Calcium Balance

Other Years Asked

  1. 1Classify bisphosphonates. Explain in detail on the mechanism of action, uses and adverse effects of bisphosphonates2024 March (Supplementary) (2019 Scheme)Short Essay · 8 marks
  2. 2A 60-year-old lady presents with back pain and in the legs. She also complains of a recent fracture in the right wrist joint. After investigation, the physician made a diagnosis of Osteoporosis. She was prescribed Alendronate. Explain the mechanism of action and adverse effects of Alendronate. (4+2)2025 March (Supplementary (SAY)) (2019 Scheme)Short Essay · 6 marks
  3. 3A 30 years old pregnant woman attended to hospital with a complaint of sudden onset of swelling of right leg and tenderness over calf. Venous Doppler of right leg suggestive of presence of a large thrombus in leg veins.2021 December (Supplementary) (2010 Scheme)Essay · 6 marks
  4. 4Bisphosphonates2015 February (2010 Scheme)Short Note · 3 marks
  5. 5Bisphosphonates2017 August (Supplementary) (2010 Scheme)Short Note · 3 marks
  6. 6Mention two important uses and adverse effects of glucocorticoids.2017 February (2010 Scheme)Short Answer · 1 mark
  7. 7Treatment of Paget’s disease2016 February (2010 Scheme)Short Answer · 1 mark
  8. 8List two advantages of low molecular weight heparin over standard heparin2013 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
  9. 9Bisphosphonates2014 March (2010 Scheme)Short Answer · 1 mark
  10. 10Treatment of osteoporosis2017 February (2010 Scheme)Short Answer · 1 mark
  11. 11Osteoporosis.2013 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
  12. 12Alendronate in osteoporosis management2022 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
  13. 13Bisphosphonates.2025 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  14. 14Bisphosphonates2025 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  15. 15Bisphosphonates2021 February (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  16. 16Bisphosphonates used in postmenopausal Osteoporosis.2022 May (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  17. 17Drugs used for osteoporosis2024 June (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  18. 18Vitamin D preparations2024 June (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  19. 19Drugs for treating Osteoporosis.2023 January (Supplementary) (2019 Scheme)Short Answer · 0.2 marks

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