Which of the following is not used in osteoporosis?
(A) Milnacipran (B) PTH (C) Strontium ranelate (D) Denosumab
(A) Ans: A. Milnacipran(Ref. Goodman Gilman 12/e p1299; Katzung 13/e p761-762, 12/e p775; Harrison 19/e p2493, 18/c' p3120; Apley 9/e p /3 I-133)Milnacipran:Serotonin-norepinephrine reuptake inhibitor (SNRI).Approved for treatment of pain in fibromyalgia, not in osteoporosis.Drugs useful in OsteoporosisInhibit Bone ResorptionStimulates Bone Both actionBisphosphonates: Alendronate, risedronate & etidronateCalcium receptor agonist: CinacalcetCalcitoninSERMs: Tamoxifen, raloxifeneGallium nitrateRANKL inhibitors: DonesumabTeriparatideCalciumCalcitriolFluorideStrontium ranelate