Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology II > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

When do men and women begin to lose bone mass?

A

30s-40s (reduced bone formation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What effect does Estrogen deficiency have during menopause

A

less estrogen increases osteoclast activity increasing bone resorption more than formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Osteoblast function

A

osteoblasts “b”uild bone!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name some drugs that cause osteoporosis

A
  1. Systemic corticosteroids
  2. Thyroid replacement
  3. Antiepileptic drugs (ex. phenytoin and phenobarbital)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors for fracture

A
  • age
  • history of fracture
  • rheumatoid arthritis
  • excessive alcohol
  • smoking
  • inflammatory bowel disease, hypogonadism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

FRAX tool

A
  • created by WHO

- uses risk factors to predict probability of fracture in next 10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Garvan calculator

A
  • uses 4 risk factors (age, sex, low-trauma fracture, falls)
  • Calculates 5 and 10 year risk of hip fracture and major bone fx

[corrects some disadvantages of FRAX)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is osteoporosis diagnosis based on?

A
  1. Low trauma fracture

or

  1. Central hip and/or spine DXA using WHO T-score thresholds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Osteopenia T score

A

T-score between -1 and -2.5

low bone mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Osteoporosis T score

A

T-score -2.5 or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Who does the T score apply to?

A
  • postmenopausal women
  • perimenopausal women
  • men 50+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who does the Z score apply to?

A

diagnosis of osteoporosis in

  • children
  • premenopausal women
  • men under 50
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the Z-score have to be to diagnose osteoporosis in children, premenopausal women, and men under 50?

A

Z score of less than 2 (in combination with other risk factors or fracture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the antiresorptive therapy of choice along with calcium and vitamin D?

A

Bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does Vitamin D increase intestinal absorption of?

A

calcium and phosphorous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the recommended dietary allowances of calcium for adults 19-50 years old?

A

1000-2,500mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the recommended dietary allowance of vitamin D for ages 9 to 70?

A

600- 4,000mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which form of calcium is better tolerated

A

Calcium citrate (but, more expensive)

calcium carbonate (gas, bloating, constipation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adverse effects of calcium supplementation

A
  1. Hypophosphotemia

2. Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you treat Vitamin D deficiency

A

50,000iu weekly for 8-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Who are bisphosphonates indicated for

A
  • postmenopausal female
  • men
  • glucocorticoid-induced osteoporosis
22
Q

Intravenous and oral ibandronate is indicated only for _______

A

postmenopausal women

23
Q

Bisphosphonate: MOA

A

inhibit bone resorption:

-decreased osteoclast maturation, number, recruitment, and life span

24
Q

Bisphosphonate 1/2 life

A

up to 10 years

25
Q

What is important to remember about taking oral Alendronate (Fosamax)

A

Take in the morning on an empty stomach and don’t eat or lie down for at least 30 minutes. Avoid taking with calcium and vitamin D

26
Q

What is important to remember about oral Ibandronate (Boniva)?

A

Take in the morning on an empty stomach and don’t eat for at least 60 minutes

27
Q

What is important to remember about Risedronate (Atelvia)?

A

Immediate release like Alendronate (take on empty stomach and wait 30 min)

Delayed release- take immediately following breakfast

28
Q

How is zoledronic acid given?

A

IV once a year

29
Q

What can be given before infusion with zoledronic acid to decrease infusion reactions?

A

acetaminophen

30
Q

When is zoledronic acid contraindicated?

A

if CrCl is <35 mL/min

31
Q

ADEs of oral bisphosphonates

A

nausea

dyspepsia

32
Q

ADEs of IV bisphosphonates

A

transient flu-like illness

33
Q

What are 2 rare and adverse effect of bisphosphonates?

A
  1. osteonecrosis of the jaw

2. Subtrochanteric femoral fracture

34
Q

Bisphosphonate contraindications

A
  1. Creatinine clearance of <30-35mL/min
  2. Esophageal abnormalities
  3. Pregnancy
35
Q

Who can be considered eligible for a “drug holiday” on bisphosphonates?

A
  1. Women without evidence of a low-trauma fracture
  2. If good response to treatment
  3. If BMD increasing to >-2 (getting into osteopenic range)
36
Q

When can a drug holiday be considered?

A

If low risk can consider stopping after 5 years of treatment

If high risk for fracture (T-score below -3.5, consider alendronate for up to 10 years

37
Q

At what age can calcitonin be used?

A

at least 5 years past menopause

38
Q

What form does calcitonin come in?

A

nasal spray

refrigerate until opening, then use at room temp

39
Q

Raloxifene (Evista) and bazedoxifene (Duavee) drug class

A

Estrogen Agonist/Antagonist

40
Q

What is Teriparatide

A

recombinant pieces of PTH

41
Q

Who is Teriparatide indicated for?

A

Very low bone density with T score

42
Q

What is important for the first dose of teriparatide?

A

patient needs to be sitting or lying down as first dose can cause orthostatic hypotension

43
Q

Teriparatide dosing?

A

daily subcutaneous injection

44
Q

Abaloparatide

A

synthetic analog of human PTH

acts as an anabolic agent to stimuate bone formation

45
Q

Who is abaloparatide used for?

A

high-risk postmenopausal osteoporosis

46
Q

Denosumab: MOA

A

RANKL inhibitor that inhibits osteoclatogenesis and increases osteoclast apoptosis

47
Q

Denosumab: ADEs

A
  • back, extremity, and musculoskeletal pain
  • increased cholesterol
  • cystitis
48
Q

When is calcitonin used?

A

LAST RESORT

49
Q

First line therapy for osteoporosis

A
  1. Alendronate
  2. Risedronate
  3. Zoledronic acid
  4. Denosumab
50
Q

What causes Osteomalacia?

A

Undermineralized bone from prolonged vitamin D deficiency

51
Q

Osteomalacia treatment?

A

Vitamin D

52
Q

What labs may be seen in osteomalacia

A

elevated alkaline phosphatase

hypocalcemia

Pharmacology II (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions