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msk 3154 > osteo > Flashcards

osteo Flashcards

1
Q

risedronate po dosage

A

35 mg per week

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2
Q

administration instructions for po bisph

A

30min before breakfast with a full glass of water. maintain upright for at least 30 mins

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3
Q

alendronate po dosage

A

70 mg per week

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4
Q

contraindications for po bisp

A

crcl <30ml/min
hypocalcemia
oesophageal/gastric/gi abnormalities
inability to sit upright ≥30 mins
aspiration risk (eg difficulty swallowing liquids)

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5
Q

se of iv bisp

A

Flu-like symptoms, worsened renal function

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6
Q

se of po bisp

A

Nausea, ab pain, heartburn, upper GI irritation

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7
Q

side effects of bisphosphonates /mabs

A

ONJ, atypical femoral fracture, muscle pain

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8
Q

how long can you take po bisph

A

5 yr

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9
Q

how long can you take iv bisph

A

3 yr

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10
Q

how often to repeat BMD

A

every 2 years

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11
Q

how much serum 25(OH) vit d should be present before initiating therapy

A

≥ 20-30 ng/ml

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12
Q

zoledronic acid (iv) dosing

A

5 mg per year as 30 min infusion

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13
Q

zoledronic acid (iv) ci in

A

crcl <35 ml/min
hypocalcaemia

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14
Q

drugs ci in hypocalcaemia

A

iv, po bisphosphonates
denosumab
calcitonins

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15
Q

drugs causing hypercalcaemia

A

teriparatide

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16
Q

first line for osteo

A

po bisphosphonates

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17
Q

how long can you use romosozumab for

A

max 1 year

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18
Q

ci for romosozumab

A

hx of cvs event/stroke, uncorrected hypocalcemia

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19
Q

administration of romo

A

once a month

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20
Q

administration of denosumab + concurrent suppl?

A

once every 6 months, 1000mg Ca + 400 IU Vit D (OD)

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21
Q

teriparatide sc

A

20 mcg OD

22
Q

teriparatide ci in

A

crcl<30
any hx of bone issues: paget’s disease/ hx of bone radiation
hypercalcemia
severe renal impairment
pregnancy

23
Q

teriparatide se

A

serious calciphylaxis, postural hypotension, transient hypocalcemia

24
Q

teriparatide can treat for how long

A

max 2 years

25
Q

raloxifene po dosage

A

50mg OD

26
Q

raloxifene ci

A

crcl <30
hx/current VTE
hepatic / severe renal impairment
hx of breast cancer

27
Q

se of raloxifene

A

vte, stroke risk

28
Q

moa of romo

A

scelerostin inhibitor. Removes sclerostin inhibition of signalling pathway that regulates bone growth, increasing bone formation and decrease bone resorption

29
Q

moa of denosumab

A

rankl inhibitor, prevents development of osteoclasts

30
Q

moa of teriparatide

A

recombinant parathyroid hormone, stimulates new bone formation, increases bone strength

31
Q

raloxifene moa

A

selective estrogen receptor modulator, mimics effects of oestrogen to maintain bone density

32
Q

ibandronate po dosage

A

150mg per month

33
Q

raloxifene preferred in

A

women without hot flushes

34
Q

list 3 non pharm for osteo

A

exercises - weight bearing, muscle strengthening

smoking cessation
limit alcohol intake
adequate calcium intake
vit d supplementation

35
Q

medications inducing osteo

A

glucocorticoids
immunosuppressants
ASM
GnRH agonists
heparin
chemotherapy
thyroid hormones

36
Q

avoid concurrent administration of calcium with

A

ppi, fibre, iron, tetracyclines, FQLs, bisphosphonates, thyroid supplements

37
Q

osteopenia bmd

A

-1 to -2.4

38
Q

osteoporosis

A

-2.5 and worse

39
Q

examples of anabolic agents

A

PTH therapies - teriparatide
sclerostin inhibitors - romo

40
Q

examples of antiresorptive agents

A

bisphosphonates

41
Q

moa bisph

A

increases osteoclast cell death, slowing bone loss

42
Q

what to screen for bisp before initiation

A

calcium, vit d deficiency

43
Q

se of denosumab

A

muscle, back, bone pain and aches
NVD
increased cholesterol
hypocalcaemia
cellulitis
eczema

44
Q

ci of deno

A

hypocalcemia, pregnancy, crcl <10

45
Q

screen prior to deno

A

scr, 25 OH vitD

46
Q

denosumab do not discontinue because?

A

increased risk of spinal column fractures

47
Q

raloxifene preferred in

A

younger women or women whose menopausal sx require concurrent tx

48
Q

raloxifene se

A

increased risk of breast cancer, blood clots, stroke/vte, hot flushes

49
Q

calcitonin moa

A

reduces blood calcium, opposes effects of PTH, inhibiting osteoclastic bone resorption

50
Q

calcitonins ae

A

red streaks on skin, injection site rxn, warm feeling, redness

51
Q

calcitonins ci

A

hypersensitivity, hypocalcemia

52
Q

romosuzumab ae

A

MI/cvs/stroke
hypocalcaemia

msk 3154 (8 decks)

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