Osteoporosis Flashcards
Calcium Recommendation
1,000 mg - 1,200 mg with 500 - 600 mg elemental calcium
Anything above –> won’t absorb
Calcium carbonate
Tums, Caltrate, Oysco
40% elelmental
Acid-dependent –> WITH meal
Calcium citrate
Calcitrate
21%
NOT acid-dependent
Take with or without meal
Bisphosphanates
- Inhibit osteoclast, preventing bone resorption
Oral: alendronate, risedronate, ibandronate
Injection: Zoledronic acid, Ibandronate
- Esophagitis, hypocalcemia, renal impairment musculoskeletal symptoms, osteonecrosis
Alendronate
Fosamax
Binosto
Risedronate
Actonel Atelvia (DR) - avoid H2RAs and PPIs completely
Ibandronate
Boniva
Zoledronic Acid
Reclast
- yearly
Estrogen agonist/antagonist - SERMs
Raloxifene (Evista)
- Antagonist in breast and agonist in bone of estrogen receptor
- Increased risk of death due to VTE and cardiovascular event; hot flashes; edemia, athralgias
Conjugated estrogen/bazedoxifene
Duavee
Less vasomotor symtom but increased risk of breast and endometrial cancer
Raloxifene
Evista
Parathyroid hormone 1-34
Analog of PTH, stimulating osteoblasts activity to increase bone formation
- Teriparatide (Forteo) - inj
- Abaloparatide (Tymlos)
- HYPERcalcemia; athralgias, leg cramps, bone pain, nausea, orthostasis/dizziness
Tepiratide
Forteo
Abaloparatide
Tymlos
Receptor Activator of Nuclear Factor kappa-B- Ligand (RANKL) inhibitor
Monoclonal antibody binding to RANKL and block its interaction to prevent osteoclast formation, decreasing bone resorption
- Denosumab (Prolia) - inj
- Osteonecrosis of jaw, femur fractures, HYPOcalcemia
