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The INBDE loves to ask the following questions on the exam.

It is no secret that the new INBDE is highly clinical in nature. The questions are arranged in a way to ensure that the test takers understand some basic science and are able to apply that information to a clinical patient box. In this blog we will uncover a topic that has been extremely high yield on the recent INBDE exam. This topic is the Bisphosphonates.


You may recall that Bisphosphonates are one of the drugs used to treat osteoporosis. A very good place to see how they work and side effects can be found in Medical News Today. Think of Bisphosphonates as (Drones), hence the word dronates is how to identify them on the exam. If it ends with dronates, then consider it a bisphosphonate.


The drones fly around the bone looking for something called hydroxyapatite. These drones have a mission and that mission is to inhibit OsteoClast activity. As a quick reminder, osteoClast = C = Crack bone. If you Crack the bone, calcium will spill into the blood causing hyperCalcemia. This makes sense that bisphosphonates would be used for conditions that causes calcium to increase in the blood such as Osteoporosis, and Paget's of the bone.


There are side effects such as corrosive esophagitis and osteonecrosis of the jaw




The three things you must know about bisphosphonates for the INBDE exam are:

  1. What is their mechanism of action and how they are pyrophosphate analogs

  2. What is their clinical use. We mentioned this above

  3. What are the major side effects?

Remember bisphosphonates are contraindicated in renal failure, hypocalcemia, lactation and pregnancy. They should be used with caution in patients with liver disease or GI disturbances (not strictly contraindicated)


If you liked this INBDE information and would like to enroll in a structured class that covers all the INBDE topics click the learn more button below.



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