Calcimiméticos

Farmacodinamia

Medicamentos de esta clase

• Cinacalcet Cinacalcet Calcimimetics: 1er medicamento de la clase
• Etelcalcetida: aprobado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 2017

Mecanismo de acción

• Receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors sensor de calcio:
  • Receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors acoplado a proteína G
  • Responde a las alteraciones en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las concentraciones de calcio extracelular
  • Ejemplos:
    • ↓ Calcio sérico → liberación de hormona paratiroidea (PTH, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) → liberación de calcio de los LOS Neisseria huesos
    • ↑ Calcio sérico → ↑ unión de calcio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors sensor de calcio → se inhibe la liberación de PTH
• Los LOS Neisseria calcimiméticos activan el receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors sensor de calcio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la glándula paratiroides → inhiben la secreción de PTH
• Esto lleva a:
  • ↓ Calcio sérico
  • ↓ Fósforo sérico

Efectos fisiológicos

Los LOS Neisseria calcimiméticos previenen la progresión de la enfermedad ósea y los LOS Neisseria efectos adversos asociados con el hiperparatiroidismo.

Farmacocinética

Absorción

• Cinacalcet Cinacalcet Calcimimetics
  • Se administra vía oral
  • Rápida absorción
  • La comida aumenta la absorción.
• Etelcalcetida: administrada por vía intravenosa

Distribución y metabolismo

• Cinacalcet Cinacalcet Calcimimetics:
  • Altamente unido a proteínas
  • Metabolizado por el sistema del citocromo P450 (CYP450)
• Etelcalcetida:
  • Forma conjugados con la albúmina.
  • No es metabolizado por las enzimas del CYP450

Excreción

• Aclarado por vía renal
• ↓ Aclaramiento en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con enfermedad renal

Indicaciones

• Cinacalcet Cinacalcet Calcimimetics:
  • Hiperparatiroidismo primario
    • Ayuda a tratar la hipercalcemia.
    • Se utiliza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes que no pueden someterse a paratiroidectomía.
    • Los LOS Neisseria bifosfonatos son una mejor opción en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con osteoporosis Osteoporosis Osteoporosis refers to a decrease in bone mass and density leading to an increased number of fractures. There are 2 forms of osteoporosis: primary, which is commonly postmenopausal or senile; and secondary, which is a manifestation of immobilization, underlying medical disorders, or long-term use of certain medications. Osteoporosis.
  • Hiperparatiroidismo secundario:
    • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con enfermedad renal crónica ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum diálisis)
    • Los LOS Neisseria estudios sugieren un ↓ riesgo de fracturas
  • Carcinoma de paratiroides: tratamiento de la hipercalcemia
• Etelcalcetida: hiperparatiroidismo secundario en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con enfermedad renal crónica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hemodiálisis

Efectos Secundarios y Contraindicaciones

Efectos secundarios

Los LOS Neisseria efectos secundarios importantes de la clase calcimimética incluyen:

• Hipocalcemia (más común con la etelcalcetida)
• Náuseas y vómitos
• Diarrea
• Mareo
• Prolongación del QTc en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el ECG ECG An electrocardiogram (ECG) is a graphic representation of the electrical activity of the heart plotted against time. Adhesive electrodes are affixed to the skin surface allowing measurement of cardiac impulses from many angles. The ECG provides 3-dimensional information about the conduction system of the heart, the myocardium, and other cardiac structures. Electrocardiogram (ECG)
• Enfermedad ósea adinámica (↓ recambio óseo debido a supresión crónica de PTH)

Contraindicaciones

• Hipersensibilidad al AL Amyloidosis medicamento o sus componentes.
• Calcio sérico < el límite inferior de lo normal

Interacciones con medicamentos

• Cinacalcet Cinacalcet Calcimimetics puede causar interacciones a través del CYP450:
  • ↑ Concentraciones de:
    • Propranolol Propranolol A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for myocardial infarction; arrhythmia; angina pectoris; hypertension; hyperthyroidism; migraine; pheochromocytoma; and anxiety but adverse effects instigate replacement by newer drugs. Antiadrenergic Drugs y carvedilol Carvedilol A carbazole and propanol derivative that acts as a non-cardioselective beta blocker and vasodilator. It has blocking activity for alpha 1 adrenergic receptors and, at higher doses, may function as a blocker of calcium channels; it also has antioxidant properties. Carvedilol is used in the treatment of hypertension; angina pectoris; and heart failure. It can also reduce the risk of death following myocardial infarction. Class 2 Antiarrhythmic Drugs (Beta Blockers)
    • Risperidona y haloperidol Haloperidol A phenyl-piperidinyl-butyrophenone that is used primarily to treat schizophrenia and other psychoses. It is also used in schizoaffective disorder, delusional disorders, ballism, and tourette syndrome (a drug of choice) and occasionally as adjunctive therapy in intellectual disability and the chorea of huntington disease. It is a potent antiemetic and is used in the treatment of intractable hiccups. First-Generation Antipsychotics
    • Amitriptilina y nortriptilina
    • Anfetaminas
    • Doxorrubicina
  • ↓ Concentraciones de:
    • Tamoxifeno
    • Tacrolimus Tacrolimus A macrolide isolated from the culture broth of a strain of streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. Immunosuppressants
• Etelcalcetida: el denosumab Denosumab A humanized monoclonal antibody and an inhibitor of the rank ligand, which regulates osteoclast differentiation and bone remodeling. It is used as a bone density conservation agent in the treatment of osteoporosis. Other Antiresorptive Drugs puede ↑ el efecto hipocalcémico

Monitoreo

Se deben controlar los LOS Neisseria niveles de calcio.

Comparación de las Clases de Medicamentos Calcimiméticos