vitohuxo's version from 2016-03-15 23:13


Question Answer
osteoporosis definitionT-score equal to or < -2.5. bone mineral density at least 2.5 standard deviations below that of an average BMD for normal young adults.
osteopenia definitionT score between -1 and -2.5
all prescription meds for low bone density require adequate _____________vitamin D and calcium taken concurrently. dietary intake calcium preferred. vitamin D required for calcium absorption. however, dietary calcium usually not sufficient!!!!!!! women need around 1300mg daily
this calcium has better absorption and can be taken without foodcalcium citrate. usual tab has 315mg of elemental calcium-21% elemental calcium. calcium carbonate needs be taken with meals.
up to 70 years old NIH recc calcium is 600 units
71 and older NIH recc calcium intake800 units, but now endocrinologits recc 800-2000 units daily.
the preferred source of vitamin D ischolecalciferol vitamin D3. the 50,000 unit vit d2 supplement ergo taken weekly 8-12 weeks to replenish stores.
sunlight exposure is vitamin D typeD3
first line most patients prevention/treatment postmenopausal osteoporosisbisphosphonates
can be rationale for use of parenteral formulations for bisphosphonatesadherence or GI issues
bisphosponates stopped after3-5 years in patients low risk fracture due to rare risk of atypical femur fracture and osteonecrosis of the jaw. high risk indefinetely or switched diff class
forteoteriparatide injection...osteoporosis who high risk fractures, already had fracture while taking bisphosponate, or cannot tolerate bisphosph.
bazedoxifeneprevents endometrial hyperplasia women with a uterus, just like progestin. it is an estrogen antagonist that is combined with estrogen.
raloxifene used when?most commonly used women risk or fear breast cancer. prevents vertebral fractures only.
calcitoninfallen out of favor due to cancer risk and is reserved for when alternatives not suitable!
bisphosphonate MOAinhibit osteoclast activity and bone resorption, ---increase bone density and reduce vertebral fractures
reclastzoledronic acid-injectible bisphosponate.
bisphosponate SEhypocalcemia, musculoskeletal pain, abdominal pain, dyspepsia, dyshpahia, heartburn, esophagitis
reclast good because?no GI problems! bypasses gut.
raloxifene MOAestrogen agonist/antagonist. women fear or risk breast cancer.
duaveeconjugated estrogens/bazedoxifene horse estrogen agonist/antagonist. women with a uterus!!!!!!!!!!!!!!
boxed warning increased risk thromboembolic events raloxifene
SE hot flashes, periph edema, arthralgiaraloxifene
calcitonin usealternate nostril daily
teriparatide (forteo) adminSubQ daily for max 18-24 months.
can cause hypercalcemiateriparatide
CI hypocalcemia bisphosphonates and denosumab (prolia)
prolia moadenosumab- monoclonal antibody binds RANKL preventing osteoclast formation.
SE back/limb pain, ezcema, rash, skin infections, increased cholesterolprolia
bisphosphonate how to takefirst thing morning before eat or drink with plain water. take while sittig up or standing and stay uprigth at least 30 mins. cannot eat or drink anything else cept water. do not take any other meds. have dental work doen before start taking!
boniva once monthly stay upright for60 mins.
take this bisphosponate after breakfast with plain water.atelvia-long acting risedronate.
teriparatide counselinginject into thigh or abdomen. may feel dizzy or light headed after first few doses. goes away within 4 hrs. make sure can lie down.
teriparatide storagekeep pen fridge aftter 28 days discard.
do not exceed 2 years of useteraparatide