Osteoperosis

Question 1

Alendronate (fosamax) - drug class, MOA, common SEs, PT implication

Answer 1

bisphosphonates

inhibit bone resorption, prevent osteoclast activity

GI disturbances, osteonecrosis of jaw, atypical femur fx

PT: take 1 hr before tx, positional d/t GI

Question 2

Risedronate - drug class, MOA, common SEs, PT implication

Answer 2

bisphosphonate

inhibits bone resorption, inhibits osteoclast activity

GI disturbances, jaw osteonecrosis, atypical femur fx

PT: take 1 hr before tx, positional awareness

Question 3

Ibandronate - drug class, MOA, common SEs, PT implication

Answer 3

bisphosphonate

inhibits bone resorption, prevents osteoclast activity

GI disturbances, osteonecrosis of jaw, atypical fx of femur

PT: take 1 hr before tx, positional awareness

Question 4

Zoledronic acid - drug class, MOA, common SEs, PT implication

Answer 4

bisphosphonate

inhibits bone resorption, inhibits osteoclast activity

GI disturbances, osteonecrosis of jaw, atypical femur fx

PT: take 1 hr before tx, positional awareness

Question 5

Raloxifene - drug class, MOA, common SEs, PT implication

Answer 5

SERM

mimic estrogen in bone, decrease bone resorption w/o stimulate breast or uterine tissue

hot flashes, leg cramps, increased venous thromboembolism

PT: may increase vertebral fx risk, watch out for SEs
*given on off day or day before

Question 6

Calcitonin - drug class, MOA, common SEs, PT implication

Answer 6

Calcitonin

decreases blood Ca level and bone resorption, inhibits osteoclast activity

nasal irritation, hot flashes

PT: may provide pain relief from acute vertebral fxs, watch out for SEs
*given on off day or day before

Question 7

Teriparatide (forteo) - drug class, MOA, common SEs, PT implication

Answer 7

Parathyroid hormone analogs

stimulates osteoblast activity, promote bone formation

leg cramps, dizziness, nausea

PT: given via daily injections, watch out for SEs
*given on off day or day before

Question 8

Denosumab (prolia, xgeva) - drug class, MOA, common SEs, PT implication

Answer 8

Monoclonal antibodies

binds and inhibits RANKL, reduces osteoclast formation, function and survival l

skin rxns at injection site, osteonecrosis of jaw, hypocalemia

PT: increases bone density and reduces fx, be aware SEs and pts w/ low Ca levels