Bisphosphonates

Question 0

bisphosphonates pt. counseling

Answer 0

• all except Atelvia: take on an EMPTY stomach 30mins before breakfast
• Atelvia: take immediately after breakfast
• take with a full glass of water to minimize esophageal burning
• stay upright for 30mins after taking

Question 1

bisphosphonates

Answer 1

Didronel
Skelid
Actonel
Atelvia
Fosamax
Fosamax Plus D
Boniva
Reclast

Question 2

osteoporosis

Answer 2

a decrease in bone density caused by bone resorption

Question 3

resorption

Answer 3

loss of a substance

Question 4

bone resorption

Answer 4

calcium moves from the bone into the blood and the bone becomes weaker

Question 5

osteoblasts

Answer 5

cells that build bone

Question 6

osteoclasts

Answer 6

cells responsible for bone resorption

Question 7

cause of osteoporosis

Answer 7

osteoclasts always function, but osteoblast function decreases with age

Question 8

bisphosphonate indications

Answer 8

osteoporosis
Paget’s Disease of the Bone
corticosteroid induced osteoporosis

Question 9

Paget’s Disease of the Bone

Answer 9

• a.k.a. osteitis deformans
• episodes of time with increased bone resorption followed by excessive attempts at repair; repaired bone is weak
• affects longer bones e.g. arms and legs
• usually occurs in people over 50

Question 10

corticosteroid induced osteoporosis

Answer 10

• occurs in pts. taking more than 7.5mg of prednisone daily

- corticosteroids decrease osteoblast function and increase osteoclast function when taken long-term

Question 11

bisphosphonate MOA

Answer 11

work by becoming part of the bone structure making it resistant to resorption so calcium stays in the bone

Question 12

Didronel

Answer 12

etidronate

-bisphosphonate

Question 13

Skelid

Answer 13

tiludronate

-bisphosphonate

Question 14

Actonel

Answer 14

risedronate

• bisphosphonate
• 35mg qweek or 150mg qmonth immediate-release tablets

Question 15

Atelvia

Answer 15

risedronate

• bisphosphonate
• 35mg enteric-coated tablet qweek

Question 16

Fosamax

Answer 16

alendronate 70mg (qweek)
-bisphosphonate

Question 17

Fosamax Plus D

Answer 17

alendronate, cholecalciferol

• bisphosphonate
• 70mg alendronate with either 70mcg or 140mcg cholecalciferol (4tabs/pk)(qweek)

Question 18

cholecalciferol

Answer 18

vitamin D

• 70mcg=2800 units
• 140mcg=5600 units
• necessary for calcium absorption, if deficient you have increased osteoclast production
• also need weight-bearing exercise

Question 19

vitamin D requirements

Answer 19

• pts. under 70yo need 600units/day

- pts. over 70yo need 800units/day

Question 20

calcium requirements

Answer 20

• women under 50yo and men under 70yo need 1,000mg/day

- women over 50yo and men over 70yo need 1,200mg/day

Question 21

Boniva

Answer 21

ibandronate

• bisphosphonate
• 150mg tablet (qmonth)
• parenteral IV (every 3 months)

Question 22

Reclast

Answer 22

zoledronic acid

• bisphosphonate
• parenteral IV (qyear)

Question 23

Forteo

Answer 23

teriparatide

• parathyroid hormone analog
• subQ injection (qdaily)
• ind. for osteoporosis
• stimulates osteoblast production and bone formation
• refrigerate always*

Question 24

Prolia

Answer 24

denosumab

• monoclonal antibody
• subQ injection (every 6 months)
• ind. for osteoporosis in pts. with a high risk of fractures (not a first-line drug)
• decreases bone resorption

Question 25

PTH

Answer 25

parathyroid hormone