Osteoporosis

Question 1

Several drug classes are used for the treatment of existing osteoporosis:

Answer 1

bisphosphonates
selective estrogen receptor modulators (SERMs)
the hormones calcitonin and teriparatide
denosumab

Question 2

The bisphosphonates work by?

Answer 2

inhibiting osteoclast mediated bone resorption, which in turn indirectly enhances bone mineral density.

Question 3

Raloxifene helps prevent osteoporosis by?

Answer 3

stimulating estrogen receptors on bone and increasing bone density in a manner similar to that of the estrogens themselves.

Question 4

Like the natural thyroid hormone, calcitonin directly?

Answer 4

inhibits osteoclastic bone resorption.

Question 5

Teriparatide is the first and currently the only drug available that acts by?

Answer 5

stimulating bone formation; it is a derivative of parathyroid hormone.

Question 6

Denosumab (Prolia) is a monoclonal antibody that blocks?

Answer 6

osteoclast activation, thereby preventing bone resorption

Question 7

The primary adverse effects of SERMs are?

Answer 7

hot flashes and leg cramps. SERMs can increase the risk of venous thromboembolism, are teratogenic, and may result in leukopenia.

Question 8

The most common adverse effects of bisphosphonates are?

Answer 8

headache, gastrointestinal (GI) upset, and joint pain. There is a risk of esophageal burns if they become lodged in the esophagus before reaching the stomach. The patient must take these medications with a full glass of water and remain sitting upright or standing for at least 30 minutes afterward.

Question 9

Common adverse effects of calcitonin include?

Answer 9

flushing of the face, nausea, diarrhea, and reduced appetite.

Question 10

Common adverse effects of teriparatide include?

Answer 10

chest pain, dizziness, hypercalcemia, nausea, and arthralgia. Infections occur with higher incidence in those taking denosumab.

Question 11

Selective estrogen receptor modulator SERMs are NOT to be used in patients who are?

Answer 11

Or may become pregnant & in women w/thromboembolic disorders including DVT

Question 12

Assessment for calcitonin (Raloxifeine)

Answer 12

• allergies to salmon with use of this drug because drug is derived from this fish
• drug interactions: ampicillin, cholestyramine=they decrease absorption
• raloxifeine also decreases effects of warfarin

Question 13

Assessment for bisphosphonates

Answer 13

drug interaction with calcium supplements and/or antacids as well as aspirin and NSAIDs