Osteoporosis Meds

Question 1

Oh my goodness, is it spring break yet?

Answer 1

I’m over this….okay back to work

Question 2

Evista: class

Answer 2

Selective estrogen receptor modulator

Question 3

Evista: MOA

Answer 3

Binds to selective estrogen receptors and decreases bone resorption

Question 4

Evista: indication

Answer 4

Px and Tx of osteoporosis

Question 5

Evista: side effect

Answer 5

Hot flashes, peripheral edema

Question 6

Evista: contraindication

Answer 6

Venous thrombosis

Question 7

Evista: Dx-Dx

Answer 7

May decrease absorption of thyroid supplements

Question 8

Do you need to cycle Evista with progestin

Answer 8

No you do not!

Question 9

Fosamax: class

Answer 9

PO Biphosphenate

Question 10

Fosamax: MOA

Answer 10

Decreases rate of bone resoprtion

Question 11

Fosamax: indication

Answer 11

Px/Tx of osteoporosis in women;
Tx of osteoporosis in men;
Tx Paget’s disease

Question 12

Fosamx: side effects

Answer 12

Esophagitis, hypophosphatemia

Question 13

Fosamax: contraindications

Answer 13

HypoCa++
Esophageal abnormalities/dysphagia
GFR below 35

Question 14

Fosamax: Dx-Dx

Answer 14

NSAIDs, antacids

Question 15

How and when do you take Fosamax?

Answer 15

In the AM with 6-8 oz of water

Question 16

I just took my Fosamax, and I’m tired. I want to lay down…

Answer 16

But I have to stay upright for at least 30 minutes after taking it.

Question 17

Reclast: class

Answer 17

IV Bisphosphenate

Question 18

Reclast: MOA

Answer 18

Inhibits osteoclast activity and skeletal Ca++ release

Question 19

Reclast: indication

Answer 19

Px/Tx of osteoporosis;

Tx of multiple myeloma, metastatic bone lesions, hyperCa++ of malignancy, Paget’s disease

Question 20

Reclast: side effects

Answer 20

Atypical Fx, ocular infection, infusion reaction

Question 21

Reclast: contraindications

Answer 21

GFR below 35

Question 22

Reclast Dx-Dx

Answer 22

Calcitonin, PPIs, NSAIDs

Question 23

Osteoporosis isn’t cool. Don’t become osteoporotic.

Answer 23

My calcium window is closed, but you still have time! Save yourself! Eat dark leafy greens!….but not arugula. Arugula is gross.

Question 24

On second thought, if you eat the arugula, there will be none left for me to eat.

Answer 24

Can I offer you seconds on this delicious arugula salad?

gag

Question 25

Teriparatide: class

Answer 25

Recombinant human PTH

Question 26

Teriparatide: MOA

Answer 26

Stimulates new bone formation

Question 27

Teriparatide: indication

Answer 27

Severe, refractory osteoporosis

Question 28

Teriparatide: side effects

Answer 28

Increased risk of bone tumors

Question 29

Teriparatide: contraindications

Answer 29

Prior bone irradiation, unexplained increased ALP, open epiphysis

Question 30

How long can you use Teriparatide?

Answer 30

2 years. Follow it with a bisphosphenate.

Question 31

Calcitonin Salmon: class

Answer 31

Calcitonin

Question 32

Calcitonin: MOA

Answer 32

Antagonizes PTH and inhibits osteoclast activity

Question 33

Calcitonin: indication

Answer 33

Osteoporosis, hyperCa++, Paget’s disease

Question 34

Calcitonin: side effect

Answer 34

Epistaxis, flushing

Question 35

Calcitonin goes in your…

Answer 35

Nose!

Question 36

What should you remember to do with with your Calcitonin Salmon every day?

Answer 36

Alternate which nare you stick it in.

Question 37

Prolia: class

Answer 37

RANK ligand inhibitor

Question 38

Prolia: MOA

Answer 38

Human monoclonal Ab attaches to RANKL so it cannot bind to RANK receptors on osteoclast surfaces. This inhibits osteoclastogenesis and promotes osteoclast apoptosis.

Question 39

Prolia: indication

Answer 39

Male and post menopausal female at high risk of Fx from osteoporosis.

Question 40

Prolia: side efects

Answer 40

Increased cholesterol
Decreased bone turnover
Osteonecrosis of jaw

Question 41

Prolia: contraindication

Answer 41

Immunosuppressive therapy

Question 42

Prolia: pregnancy class

Answer 42

X

Question 43

On what schedule do you take Prolia?

Answer 43

60mg SQ q6 months