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Osteoporosis
Osteoporosis
43
Pharmacology
Professional
09/26/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
The most common location of a fracture for those with osteoporosis?
Definition

Lower Lumbar spine

 

Term
Hip fractures serious?
Definition

YES! Hip fractures occur within more severe disease (or bad falls) and can be debilitating. A hip fracture in a woman has a 25% risk of mortality at one year, and is higher in men, since men with osteoporosis are often using long-term steroids or androgen blockers and may be sicker at baseline.

Term
Osteoporosis is defined by a T-score < ___?
Definition
2.5
Term

Osteopenia is lower bone density than normal, but not as low as osteoporosis. Osteopenia is defined by a T-score between?

Definition
-1 and -2.5
Term
Osteoblasts do what?
Definition
build bone
Term
Osteoclasts do what?
Definition
break-down bone
Term
What is the name of technology used to do a bone scan?
Definition
DEXA, or DXA
Term
Risk factors for low bone density?
Definition
[image]
Term

All prescription medicines for low bone density require _____ and ____ supplementation taken concurrently.

Definition
adequate calcium and vitamin D
Term
Why is vitamin D needed?
Definition

Vitamin D is required for calcium absoprtion, and low levels contribute to various health conditions

Term
Vitamin D shoud  always be used with?
Definition

Caclium! There is an increased risk of heart attack should Vitamin D be used alone!

Term
What is the major drug that contributes to bone loss?
Definition

Steroid Use (long term): is the major drug-contributing factor to poor bone health.

 

Other medications include:


Anticonvulsants

Warfarin & heparin

Excess thyroid hormone

Loop diuretics

Aromatase inhibitors use for breast CA

Androgen blockers used for prostate CA


Proto Pump inhibitors chornically (decrease calcium absorption due to decreased gastric pH)

Term
Recommended adequate intakes for calcium (2010) for 50+
Definition
[image]
Term
Is calcium absorption saturable?
Definition

Yes. Calcium absorption is saturable; dose should be divided

Term
Brand name for Calcium citrate
Definition
Citracal
Term
What's unique about clacium citrate?
Definition

Better absoprtion

Larger pill to swallow

Can be taken without food


Preferable to little or not stomach acid (such as those taking PPIs which have been shown to increase fracture risk due to impaired calcium carbonate absorption)

Term
Brand name for calcium carbonate?
Definition

Oscal, Tums

 

Term
What is so special about calcium carbonate?
Definition

Acid-dependent absorption and should be taken with meals

 

(So, one wouldn't give this with calcium citrate)

Term
Are there chewable forms of calcium supplements?
Definition

YES! Both forms (calcium citrate and calcium carbonate) come in chewable formulations

Term
Recommended intake for vitamin D for people up to age 70 is
Definition
600 IU daily
Term
Recommended intake for vitamin D for people up to age 71+ years is ?
Definition
800 IU daily
Term

The 50,000 unit vitamin D2 supplement (the green capsules) are used in ___ ____ or short-term in adults with deficiency to replenigh stores

Definition
renal disease
Term
What is cholecalciferol?
Definition

Vitamin D3

 

Note: vitamin D2 is often the type in supplements and will provide benefit

Term
What class of medication is first line for osteoporosis?
Definition

Bisphosphonates: increase bone density more than estrogen and raloxifene, and reduce fracture risk

Term
Brand name for teriparatide?
Definition
Forteo
Term
When is forteo indicated?
Definition

in patients with osteoporosis who are at high risk for having fractures, or have already had an osteoporotic fracutre, or have OP and need to take long-term steroids, or who cannot tolerate bisphophonates

 

So, basically, it is not first line!

Term
Will a pharmacist most likely dispense the newer agent denosumab (Prolia)
Definition

most likelyl not; it is expensive and administered in a doctor's office

Term
Is estrogen considered first line?
Definition

NO, not for osteoporosis because of health risks

 

Term
Raloxifene is used most commonly in women who are at risk or have fear of ____ ___?
Definition
breast cancer
Term
Is calcitonin used commonly for osteoporosis?
Definition
NO, not anymore; there is poor beneficial evidence
Term
Brand name for risedronate?
Definition
Actonel
Term
Brand name for Ibandronate?
Definition
Boniva
Term
Brand name for Zoledronic Acid?
Definition
Reclast
Term
Brand name for Raloxifene
Definition
Evista
Term
Which bisphosphonate is injectable?
Definition
Zoledronic Acid (Reclast)
Term
[image]
Definition
Statement. Not a question.
Term

[image]

[image]

Definition
Statement. Not a question.
Term
Bisphosphonate Counseling
Definition
[image]
Term
What do should one miss a bisphophonate dose?
Definition

If on weekly schedule and missed one dose, take the following morning (but not 2 doses in 1 day)

 

If on daily schedule missed one dose, skip until next dose

 

If on monthly Boniva and miss a dose, take it as soon as your remember (in the morning before eating) except if it less than one week to the next dose, skip it (can't take 2 doses in one wek)

Term
Which bisphosphonat is given monthly?
Definition
Ibandronate (Boniva)
Term
Counseling for Reclast Injection
Definition

Make sure patient is NOT using Zometa since it is the same drug. Immediately after injection, low serum calcium can occur. This is aggravated if on aminoglycosides, and these should not be used concurrently.

 

It is necessary to take 1500 mg calcium in divided doses (2-3 doses daily) for the 2 weeks after the injection and 1200 mg the rest of the year, and 800 IU vitamin D throughout the year

 

 

Term
Teriparatide  counseling
Definition
[image]
Term
Calcitonin Nasal Spray Counseling
Definition
[image]
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