Osteoporosis

Question 1

What is recommended calcium dose?

Answer 1

1000 in women 25-50 and postmenopausal women on estrogen 50-65yo.
1500 in 50-65yo if not on estrogen
1500 in >65yo regardless
1200-1500 in pregnant and nursing women.

Question 2

Recommended dose of Vit D

Answer 2

400-800IU

Question 3

What is the role of estrogen in osteoporsis

Answer 3

suppresses IL6 secretion with inhibition osteoclast recruitment

Question 4

What is the dosing regimen of estrogen

Answer 4

0.625-1.25mg per day conjugated estrogen cycled or continuous with progesterone 2.5 - 10mg

transdermal estradiol 0.05 to 0.10mg weekly

use progesterone to decrease buildup of endometrium

Question 5

recommended dosing of calcitonin

Answer 5

Nasal spray 1 spray 200IU daily, alternate nostrils

Parenteral injection SC or IM: prevention 100(* EOD or treatment 100IU daily

Question 6

Name the 4 bisphosphonates used to treat OP

Answer 6

Alendronate (Fosamax) - 5mg daily prevention or 10mg daily treatment

Risedronate (actonel) - 5mg daily or 35mg weekly or 75mg twice monthly

Ibandronate (Boniva) - 2.5mg daily or 150mg monthly; 3mg IV every 3 months

Zaledronic acid (reclast) - 5mg IV yearly

Question 7

What ist he recombinant form of human PTH used to treat OP

Answer 7

Teriparatide (Forteo) - 20mcg SC daily - can use for up to 24 y

Question 8

What is the medication to use if patient’s cannot take estrogen due to contraindications?

Answer 8

Selective estrogen receptor modulators

Raloxifene (Evista) 60mg daily