ch 61 highlights Flashcards
Vit d requirements in relation to age
increases with age
cells that resorb (break down) old bone
osteoclasts
cells that deposit new bone and increase bone madss
osteoblasts
foods that suppress calcium absorption
oxalic acid - found in spinach, rhubarb, swiss chard and beets
calcium reduces the effectiveness of what antibiotics
quinolones and tetracyclines - take 2 hours apart from the med
if have gi upset with calcium carbonate
switch to calcium citrate - better absorbed/tolerated
calcium is excreted in the
kidney
Bisphosphonates
-ate
Alendronate
Risedronate
Ibandronate
Zoledronic Acid
what is your first line Bisphosphonates
Alendronate
patient education alendronate
can cause esophagitis
Take with full glass of water and sit/stand for at least 30 min after
use for Risedronate
approved for postmenopausal osteoporosis
male osteoporosis, GIOP and Paget disease
Bisphosphonate that is only approved for postmenopausal osteoporosis
Ibandronate (Boniva)
what will decrease calcium
glucocorticoids
leafy greens
To ensure adequate absorption of Calcium, no more than ____mg at one time
600
calcium decreases absorption of what hormones
thyroid
what type of calcium is more consistent bioavailability
chewable
how to take bisphosphonates
take these drugs in thte
Perenteral calcium may cause severe bradycardia in pt taking
Digoxin - monitor HR closely
Zoledronate will increase/decrease r/o osteonecrosis of jaw as compared to Alendronate (Fosamax)
increased
Zoledronate is given
IV 1-2 years
zoledronate the pt will need
regular dental checks to monitor for osteonecrosis of jaw
adequate amount of Vit D are gained through
fortified foods
supplements
exposure to sunlight
Which is preferred vit D 3 or Vit D2
Vit D3
If Ca is not sufficient will vit D be absorbed
Vit D can promote bone decalcification if CA is not sufficient
Vit D acts to increase Calcium and phosphorous absorption from
intestine
Treatment for osteoporosis that can protect against breast cancer
Raloxifene (Evista)
Pt taking risedronate (Actonel) for osteoporosis is having diarrhea, rash, nausea, arthralgia and headache. What will the nurse tell them
This is common side effects and not a symptom of toxicity
Forteo pen needs to be replaced every
28 days
symptoms of hypocalcemia
weakness fatigue n/v constipation nocturia
vit d tox can occur
stop vit d, reduce ca and increase fluids
Taking Raloxifene (Evista) be cautious on long flights for
DVT
