Osteoporosis Flashcards
Calcitrol
Rx Vitamin D that can increase bone mass
Can dangerously increase calcium
Calcium supplementation recommendations
Under 50- 1000 mg/day
Over 50- 1200-1500 mg/day
breast-feeding women 2000 mg
Magnesium supplementation
300mg-1000mg
Give with vitamin D and calcium
may cause loose stool
Strontium/ Protos
Improves osteoblastic activity
500 mg- 1 g daily for prevention and 2g for osteoporosis pts
Dosing too high can actually weaken bone
Bisphosphonates generals
inhibit osteoclast activity
commonly cause upset stomach and EROSIONS OF ESOPHAGUS.
Osteonecrosis of the jaw, atypical femur fractures, myalgias
Alendronate/Fosamax
Bisphosphonate for prevention and tx of osteoporosis.
Works by inhibiting osteoclasts
Sides: erosive esophagitis, atypical femur fractures, myalgias, osteonecrosis of the jaw
SERMS- selective estrogen receptor modulators
attempt at giving the same benefits of estrogen and cholesterol without the increased risk for hormone related cancers
Bind to Estrogen receptors in bones and lipids only
Roloxifene/Evista
SERM to increase bone mass.
Sides: hot flashes, arthralgias, myalgias, edema, pruritius, increased DVT risk
Calcitonin/Miacalcin
synthetic hormone to increase serum calcium (only existing osteoporosis)
inhibits osteoclast activity
comes in nasal spray or IV
Teriparatide/Forteo
synthetic PTH analogue for those with high fracture risk. Women all fractures and men only vertebral
Activates bone turnover with more blasts than clasts
SQ- use up to 24 months
Estrogen/HRT
esterefied estrogens have less risks than equine estrogens
Sides: vag bleeding, breast tenderness, DVT
Increased risk gallbladder dz, breast CA, stroke, MI
Denosumab/Prolia
human monoclonal Ab for osteoporosis, bone mets, RA, mult myeloma, giant cell bone tumors Targets RANKL only approved for tx SQ injection every 6 months Diminishes immune system
3 classes of phytoestrogens
Isoflavones
Lignans
Coumestans
