Osteoporosis Flashcards
Osteoporosis Definition
Skeletal disorder of compromised bone strength which increases risk for fracture.
Medications that contribute to osteoporosis
- Glucocorticoids
- Anticonvulsants
- Chemotherapy
- Lithium
- Heparin
Most important hormone modulator of bone
Estrogen
First line treatment for osteopenia
Calcium supplement + vitamin D
Bisphosphonate examples and uses
Alendronate, risedronate, Ibandronate and zoledronic acid
Used in osteoporosis, Hypercalcemia, Paget’s disease
Bisphosphonate contraindications/precautions and education
Avoid in hypocalcemia and creatinine clearance less than 30cc/min
Do not initiate without normal calcium levels
Take on empty stomach in morning. Sit upright for 30 minutes after administration.
Bisphosphonate Adverse Effects
Abdominal pain, diarrhea, flatulence, esophagitis, bone pain (with Paget’s disease), osteonecrosis of jaw, long bone fracture with prolonged use
-Constipation in Risindronate
Calcitonin (nasal spray) adverse effects
Nasal stuffiness
?? increased risk for cancer
Raloxifene drug class and mechanism of action
Selective estrogen receptor modulator (SERM)
Acts as an estrogenic agonist on bone
Estrogenic antagonist on breast (protective against breast cancer)
Raloxifene indications and contraindications
Indicated in post menopausal osteoporosis, and high risk for breast cancer
Contraindications: hx of VTE, nursing or pregnant
Raloxifene adverse effects
Intensify postmenopausal symptoms (hot flashes)
DVT, pulmonary embolism
leg cramps
***Black box warning: increased risk for death following stroke***
Denosumab mechanism of action
Inactivation of osteoclastic gene transcription by inhibition of RANKL (transmembrane protein).
