EXAM 1 (BONES MEDS)

Question 1

What are the goals of osteoporosis treatment?

Answer 1

risk reduction and fracture prevention. increase vit d and ca

Question 2

difference in Ca supplementation dosage in young adults and older adults

Answer 2

YA: 1k
OA: 1.2k

Question 3

You must get a rating of ___ or below on the DXA scale in order to be dx with osteoporosis

Answer 3

-2.5 or less

Question 4

Generally, what are the two types of drugs used to treat osteoporosis?

Answer 4

drug decreases bone resorption OR drug increases bone formation

Question 5

what osteoporosis Tx drug is the only one that increases bone formation

Answer 5

teriparatide, all other drugs decrease bone resorption

Question 6

drugs that decrease bone resorption need to be started _____

Answer 6

early. Immediately after menopause for women and as soon an men turn fifty

Question 7

What drug is a SERM (Selective Estrogen Receptor Modulator) and will likely be asked about a lot on the test?

Answer 7

Raloxifine (evista).

It mimics estrogens effect on bone lipids and clotting, but doesn’t bother breasts or endometrial tissue. DONT GIVE TO PREGNANT PEOPLE! PO

Question 8

Whats an example of a bisphosphonate tx for osteoporosis

Answer 8

Alendronate

Biphosphate is already in the bone naturally and tends to tell osteoclasts to GO AWAY.

Can irritate your esophageal tissue if not taken with enough water to get it all in the stomach. Might make ya bones hurt. PO

Question 9

Whats an example of a calcium metabolism modifier tx for osteoporosis

Answer 9

Calcitonin

NOT FIRST LINE MED b/c it doesn’t help w/ fractures. Naturally released by the thyroid when calcium blood levels are too high. Makes you pee out all your calcium by INHIBITING OSTEOCLASTS. You would usually sniff this up your nose or do an SQ injection.

Question 10

Whats an example of a monoclonal antibody tx for osteoporosis

Answer 10

Denosumab (prolia)

Binds with RANKL so RANK doesn’t get activated so decreased formation/function of osteoclasts. Can cause bone pain, high cholesterol, and bladder infections. Given SQ

Question 11

Whats an example of a parathyroid hormone faker tx for osteoporosis

Answer 11

Teriparatide (forteo)

Daily SQ med. Increases osteoblast activity and forms more bone.

Question 12

what is the 1st line treatment for osteoarthritis

Answer 12

1st GEN NSAIDs (Ibuprofen). Inhibits COX-1 (ALL TISSUE/THINS BLOOD), AND COX-2 (INJURED TISSUE/STROKE MI)

Dont take lithium or SSRIs

Question 13

Whats the topical NSAID to know

Answer 13

Volatren/Diclofenac

Question 14

what are the 2nd gen nsaids to know

Answer 14

celecoxib/celebrex

Doesn’t touch COX -1 (for people w/ platelet/kidney/GI issues) and selectively inhibtis COX-2

Question 15

what meds do you use to control Sx of RA

Answer 15

SHORT TERM: NSAIDs, glucocorticoids

LON TERM: DMARDs

Question 16

whats a DMARD

Answer 16

RA drug DISEASE MODIFYING ANTI-RHEUMATIC DRUG

Reduce joint destruction and slow disease progression

3 categories, conventional (traditional) DMARDs, biologic DMARDs, and targeted DMARDs

Question 17

WHATS METHOTREXATE USED FOR

Answer 17

Most effect RA DMARD

works better (80% success) and faster (efects start w/in 3-6 weeks) and cheaper

Methotrexate is a folate antagonist.

no pts w/ pregnancy, liver, gi problems. no alcohol or live vaccines

get vaccines before starting med

TAKE W/ FOLIC ACID to avoid gi issues

Question 18

whats a biologic DMARD

Answer 18

etanercept (enbrel)

immunosuppressant that stops tumor necrosis factor

super pricey, full effect in 3-6 weeks

Question 19

whats a targeted DMARD