Select a medication using the treatment guidelines for osteoporosis, thyroid disorder, or diabetes mellitus. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions, including interactions with CAM. Discuss evidence and treatment guidelines to determine appropriate therapeutic options for a patient with osteoporosis, thyroid disorder, or diabetes mellitus. Discuss ethnic, cultural, and genetic considerations that must be considered for treatment. In addition, share a clinical trial that supports the use of this agent. Include the name of the medication in the subject line so that the medications can be followed. Make sure you choose a different medication from your peers. Include references using APA format.
Topic 7 DQ 1
Course Code and Name
Topic 7 DQ 1
Teriparatide is an anabolic medication FDA approved for the treatment of osteoporosis (Tu et al., 2018). Mechanism of action: Teriparatide influences bone metabolism by binding to the parathyroid hormone type 1 receptor using the N-terminal, leading to activation of Gs mediated activation of adenylate cyclase and Gq mediated activation of protein kinase. The result is a cascade of activities that lead to osteoblast survival and an increase in number through osteoclast differentiation and activation (Vall & Parmar, 2022). Teriparatide also influences calcium and phosphate homeostasis by stimulating distal calcium reabsorption in the kidneys and inhibiting phosphate reabsorption in the proximal tubule (Vall & Parmar, 2022). It also mobilizes calcium from the bone matrix into circulation.
Monitoring: Measure serum calcium level at one month of treatment, followed by subsequent measurements based on the previous serum calcium levels. Measure serum and urine calcium before beginning treatment (Whitaker Elam et al., 2021). Side effects: common side effects include nausea, headaches, hypercalcemia, hypercalciuria and dizziness. Researchers observed osteosarcoma in rats at high doses, but there was no significant inference to humans (Tu et al., 2018). Treatment recommendations include using Teriparatide for initial Post-menopausal in women with prior fragility structures or high fracture risks. Teriparatide is also used for those unable to take oral therapy to treat osteoporosis. Patients follow the therapy with an antiresorptive medication to prevent loss of bone density after treatment with Teriparatide. A large study across the United States, Europe, and Japan on patients treated with Teriparatide reveals the patients as mostly Caucasian, post-menopausal women, and a few men. The mean age was 71 years though a few patients younger than 70 demonstrated smaller gains in bone density than those older than 71 years (Hauser et al., 2021). Random controlled trials in both men and women show similar gains in bone density.
Hauser, B., Alonso, N., & Riches, P. L. (2021). Review of current real-world experience with Teriparatide as treatment of osteoporosis in different patient groups. Journal of Clinical Medicine, 10(7), 1403. https://doi.org/10.3390/jcm10071403
Tu, K. N., Lie, J. D., Victoria Wan, C. K., Cameron, M., Austel, A. G., Nguyen, J. K., Van, K., & Hyun, D. (2018). Osteoporosis: A Review of Treatment Options. Pharmacy and Therapeutics, 43(2), 92-104. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768298/
Vall, H., & Parmar, M. (2022, January 6). Teriparatide – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK559248/
Whitaker Elam, R. E., Jackson, N. N., Machua, W., & Carbone, L. D. (2021, November 9). Osteoporosis treatment & management: Approach considerations, pharmacologic therapy, dietary measures. Drugs & Diseases – Medscape Reference. https://emedicine.medscape.com/article/330598-treatment#d8