A 60-year-old postmenopausal woman with osteoporosis (T-score -3.0) has failed bisphosphonate therapy due to recurrent vertebral fractures. Her physician plans an anabolic agent that stimulates osteoblast-mediated bone formation by intermittent PTH receptor activation. The drug is:
- A Denosumab
- B Teriparatide ✓
- C Raloxifene
- D Zoledronic acid
Correct answer: B. Teriparatide
Explanation
Teriparatide is recombinant PTH (1-34), an anabolic agent given as a daily subcutaneous injection. Intermittent exposure activates osteoblasts more than osteoclasts, net increasing bone formation. Denosumab and zoledronic acid are antiresorptive. Raloxifene is a SERM, also antiresorptive. Teriparatide is indicated for severe osteoporosis or failure of antiresorptive therapy.
Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.
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