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Board Study Topics > 00 Osteoporosis and HRT > Flashcards

00 Osteoporosis and HRT Flashcards

1
Q

What is the definition of Osteoporosis?

A

T-score < -2.5

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2
Q

What is Osteopenia?

A

Lower bone density than normal, but not as low as osteoporosis (T-score between -1 and -2.5)

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3
Q

What are some drugs that can increase the risk of Osteoporosis?

A

Long-term steroid use, Anticonvulsants, Warfarin/heparin, Loop diuretics, PPIs, etc.

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4
Q

What is important about calcium absorption?

A

Calcium absorption is saturable; doses should be divided. Requires vitamin D for absorption

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5
Q

What drug treatment is often used first line for osteoporosis?

A

Bisphosphonates. PO or IV

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6
Q

How long should bisphosphonates be used for?

A

D/t the risk of atypical femur fracture, esophageal cancer, and osteonecrosis of the jaw, bisphosphonates should be stopped after 3-5 years

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7
Q

Why is estrogen no longer used first line?

A

Health risks, however, if used for menopausal symptoms, estrogen does increase bone density

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8
Q

What is most commonly used for women who are at risk or have fear of breast cancer?

A

Raloxifene

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9
Q

What is the generic name of Fosamax?

A

Alendronate (Bisphosphonate) - PO

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10
Q

How is Fosamax (Alendronate) usually dosed?

A

70mg PO weekly (or 10mg PO daily)

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11
Q

What is the generic name of Actonel, Atelvia?

A

Risedronate (Bisphosphonate) - PO

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12
Q

What is the generic name of Boniva?

A

Ibandronate (Bisphosphonate) - PO

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13
Q

What are the contraindications of Bisphosphonates?

A

Inability to stand or sit upright for at least 30 minutes (60 minutes w/ once-daily Boniva). Hypocalcemia. CrCl < 35

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14
Q

What are some commonly seen side effects with Bisphosphonates?

A

Hypocalcemia (mild, transient), back pain, arthralgias, dyspepsia, N/V, dysphagia, heartburn, esophagitis

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15
Q

What is the generic name of Reclast?

A

Zolendronic Acid (Injectable Bisphosphonate)

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16
Q

What is the generic name of Evista?

A

Raloxifene (Estrogen agonist/antagonist, SERM)

17
Q

What is the BBW with Evista (Raloxifene)?

A

Increased risk of DVT/PE/MI/Stroke

18
Q

What are the commonly seen side effects with Evista (Raloxifene)?

A

Hot flashes, peripheral edema, hot flashes, arthralgia, leg cramps/muscle spasms, flu-like syndrome, infection, amenorrhea, vaginal bleeding/discharge, skin changes

19
Q

What is important about the Calcitonin Nasal Spray?

A

Inhale 1 spray daily (alternate nostril daily)

20
Q

What is the generic name of Forteo?

A

Teriparatide (Injection - stimulates bone formation)

21
Q

When is Forteo (Teriparatide) used?

A

For patients who are at very high risk for fracture, or have already had a fracture d/t osteoporosis

22
Q

How is Forteo (Teriparatide) dosed?

A

20mcg SC inj daily for MAX of 2 years!

23
Q

What is the BBW with Forteo (Teriparatide)?

A

Osteosarcoma (bone cancer)

24
Q

What is the generic name of Prolia?

A

Denosumab (Monoclonal antibody)

25
Q

What are the contraindications for Prolia (Denosumab)?

A

Hypocalcemia

26
Q

What are the side effects with Prolia (Denosumab)?

A

Fatigue, Hypocalcemia (correct), Eczema, Rash, Weakness, Arthralgia/weakness/limb pain, nausea, dyspnea, cough

27
Q

For HRT, when should Estrogen be used/not be used?

A

In women with a uterus, estrogen should not be given alone

28
Q

What are the risks of using estrogen w/ progestin?

A

Increases breast cancer risk, and the use of this combination should be limited to 3-5 years

29
Q

What are some natural products used for vasomotor symptoms of menopause?

A

Black cohosh, Red clover, Soy, Flaxseed

30
Q

Which antidepressant is approved for menopause symptoms?

A

Brisdelle (Paroxetine): not recommended, especially in older people. Do not use with warfarin (increased risk of bleeding)

31
Q

What is the generic name of Vivelle?

A

Esradiol transdermal system twice weekly patch for menopause

32
Q

Besides the Vivelle patch, what are some other hormonal products used for menopause?

A

Provera, Premarin (tab and cream), Prempro

33
Q

How is Evista (Raloxifene) dosed?

A

60mg/day

34
Q

How is Alendronate (Fosamax) dosed for prevention?

A

35mg once a week

35
Q

How is Risedronate dosed?

A

35mg QWeek or 150mg QMonth for prevention or treatment

36
Q

How is Reclast (Zolendronic acid) dosed for post-menopausal osteoporosis?

A

5mg IV once yearly infused over 15 minutes

37
Q

What is the generic name of Miacalcin?

A

Calcitonin (nasal spray for osteoporosis)

Board Study Topics (38 decks)

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