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Exam 3 > Agents for Osteoporosis > Flashcards

Agents for Osteoporosis Flashcards

1
Q

Calcium is critical for what?

A

Proper functioning of the nervous, muscular and cardiovascular systems.

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2
Q

Adequate levels of calcium are necessary for the body to do these four things.

A
  • Transmit nerve impulses
  • Prevent muscle spasms
  • Provide stability and movement
  • Provide for blood coagulation and myocardial activity.
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3
Q

What system controls calcium and what glad does it begin in?

A

The endocrine system and begins in the parathyroid gland.

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4
Q

Parathyroid hormone does what to calcium in the blood?

A

It increases it.

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5
Q

The parathyroid recreates what type of hormone that directly effects calcium.

A

Parathyroid hormone (PTH)

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6
Q

Parathyroid hormone (PTH) stimulates what?

A

Stimulates osteoclasts and accelerates bone resorption.

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7
Q

Parathyroid hormone (PTH) increases absorption of calcium where?

A

In the GI tract.

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8
Q

Where is calcitonin secreted from and what does it stimulate?

A

Secreted by thyroid gland.

Stimulates bone deposition.

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9
Q

PTH and calcitonin control what?

A

Calcium homeostasis

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10
Q

PTH and calcitonin influence what three targets?

A

Bones, kidneys, and gastrointestinal tract.

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11
Q

Low levels of calcium in the bloodstream cause what to be released?

A

PTH

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12
Q

Parathyroid glands cause what three things as a response to PTH release that result in higher levels of calcium in the blood stream.

A
  1. Release of calcium from bone
  2. Increased calcium reabsorption from the kidneys
  3. Increased absorption of calcium in small intestine (with help of calcitriol or vitamin D)
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13
Q

Higher levels of calcium in the blood stream cause what to be released?

A

Calcitonin release

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14
Q

The thyroid gland causes what two things as a response to calcitonin release and results in lower levels of calcium in the bloodstream?

A
  1. Addition of calcium to bone

2. Decreased absorption of calcium in small intestine

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15
Q

Vitamin D is necessary for effective absorption of what?

A

Calcium

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16
Q

Vitamin D is synthesized from what?

A

Precursor molecules

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17
Q

Cholecalciferol is converted and metabolized into what?

A

Calcitriol

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18
Q

Calcitriol is the active form of what?

A

Vitamin D

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19
Q

What are the four types of pharmacotherapy that are used to treat osteoporosis?

A
  • Calcium and vitamin D supplements
  • Bisphosphonates
  • Estrogen receptor modulators
  • Calcitonin
20
Q

What type of pharmacotherapy is no longer recommended to treat osteoporosis?

A

Hormone replacement therapy (HRT)

21
Q

Alendronate belongs to what class of drugs?

A

Bisphosphonates

22
Q

What is the action for Alendronate?

A

Blocks bone resorption by inhibiting osteoclast activity, increases bone density

23
Q

What is Alendronate’s primary use?

A

For prevention and treatment of osteoporosis

ALSO for paget’s disease

24
Q

When do you need to use caution when administering Alendronate?

A
  • kidney disease due to it excreting virtually unchanged
  • hypocalcemia
  • pregnancy and lactation
  • Upper GI disease
25
Q

What are the adverse effects for Alendronate?

A
  • Heart attack
  • Nausea/vomiting/diarrhea
  • GI irritation
  • Esophageal erosion
  • Dental issures
  • Femoral fracture
  • Myalgias
  • Hypocalcemia
26
Q

What should you make sure to teach your patient if they are taking Alendronate?

A

Take it with a full glass of water on an empty stomach first thing in the morning and stay up right

27
Q

What does SERMs stand for?

A

Selective Estrogen Receptor Modulators

28
Q

What class does Raloxifene belong to?

A

Selective Estrogen Receptor Modulators (SERMs)

29
Q

What are the four things that Raloxifene does?

A
  • Decreases bone resorption
  • Increases bone mass and density by acting through estrogen receptor
  • Reduces vertebral fractures
  • Decreases total cholesterol and LDL
30
Q

What is the primary use for Raloxifene?

A

-Prevention of osteoporosis in post menopausal women

31
Q

What are the adverse effects of Raloxifene?

A
  • Hot flashes
  • Migraine headaches
  • Flu-like symptoms
  • Endometrical disorder
  • Breast pain
  • Vaginal bleeding
32
Q

What is the pregnancy category for Raloxifene?

A

X

33
Q

What is the contraindication for Raloxifene?

A

History of venous thromboembolism

34
Q

What type of fish is calcitonin found in?

A

Salmon

35
Q

How does calcitonin increase bone density?

A

By inhibiting bone resorption and opposing the effects of PTH lowering the serum calcium blood levels.

36
Q

How is calcitonin administered?

A

By nasal spray or SQ

37
Q

What should you do before administering calcitonin SQ?

A

skin test first

38
Q

What are the adverse effects for calcitonin that is give SQ?

A

Anaphylaxix, nausea, vomiting, flushing

39
Q

What are the uses for calcitonin?

A
  • Osteoporosis
  • Paget’s disease
  • Emergency treatment of hypercalcemia
40
Q

When is giving calcitonin contraindicated?

A

Allergy to salmon or fish

41
Q

What drug interacts with vitamin D therapy?

A

Cholestyramine

42
Q

What labs should you monitor when giving vitamin D therapy?

A
  • Liver and renal function
  • Magnesium levels
  • Calcium and phosphate levels
43
Q

When giving a calcium supplement you should assess for signs and symptoms of what?

A

Hypercalcemia

44
Q

What are the signs and symptoms of hypercalcemia?

A
  • Drowsiness
  • Lethargy
  • Weakness
  • Headache
  • Anorexia
  • Nausea
  • Vomiting
  • Thirst
  • Increased urination
45
Q

What are signs and symptoms of hypocalcemia?

A
  • Facial twitching
  • Muscle spasms
  • Parethesias
  • Seizures
46
Q

What should the nurse teach the client about taking Alendronate?
A. Take this drug first thing in the morning on an empty stomach.
B. Take this medication with a full glass of milk to prevent GI irritation.
C. Take this medication at bedtime to avoid the flushing effects.
D. Take this medication to increase your serum calcium levels.

A

A. Take this drug first thing in the morning on an empty stomach.

Exam 3 (8 decks)

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