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osteoporosis menopause testosterone Flashcards

1
Q

osteoporosis is most common in

A

postmenopausal females

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2
Q

what patient characteristics are associated with osteoporosis risk

A

adv age, caucasian or asian, family history, female, low body weight

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3
Q

what medical diseases/conditions are associated with osteoporosis risk

A

diabetes, eating disorder, GI diseases, hyperthyroidism, hypogonadism in men, menopause, RA or autoimmune disease (also epilepsy, HIV/AIDS, PD)

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4
Q

what lifestyle factors are associated with osteoporosis risk

A

smoking, excessive alcohol, low calcium, low vit D, physical inactivity

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5
Q

what medications are associated with osteoporosis risk

A

anticonvulsants, aromatase inhibitors, DMPA, Li, GnRH agonists, PPI, steroids (>5mg prednisone), thyroid hormone (also loop diuretics, SSRI, TZDs)

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6
Q

gold standard for measuring BMD

A

DXA scan

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7
Q

when should you have BMD measured

A

65 yo females, 70 yo males (earlier if history of fractures after 50yo)

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8
Q

FRAX estimates

A

risk of osteoporosis fracture in next 10 years

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9
Q

calcium absorption is aided by

A

vitamin D

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10
Q

vitamin D deficiency causes

A

rickets in kids, osteomalacia in adults

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11
Q

recommended calcium intake in adults is

A

1000-1200 mg

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12
Q

calcium carbonate contains what percent of elemental calcium

A

40%

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13
Q

calcium citrate contains what percent of elemental calcium

A

21%

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14
Q

important counseling points for calcium carbonate

A

take with food (requires acidic environment), do NOT use with PPI

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15
Q

cholecalciferol

A

D3

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16
Q

ergocalciferol

A

D2

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17
Q

how much cholecalciferol is recommended for vitamin D deficiency

A

5000-7000 IU daily

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18
Q

how much ergocalciferol is recommended for vitamin D deficiency

A

50000 IU weekly

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19
Q

tums

A

calcium carbonate

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20
Q

major side effect of calcium supplement

A

constipation

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21
Q

which drugs are indicated for prevention of osteoporosis

A

All bisphosphonates except ibandronate IV (PO okay), estrogen-based therapy, ralosifene, Duavee

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22
Q

which drugs are indicated for treatment of osteoporosis

A

bisphosphonates, denosumab, PTH analogs, calcitonin

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23
Q

important counseling for bisphosphonates

A

remain upright for 30 min (60 for ibandronate) and drink 6-8oz water

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24
Q

denosumab route of administration

A

SC

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25
Side effects of bisphosphonates
esophagitis, hypocalemia
26
side effect of denosumab
hypOcalcemia
27
how frequently is denosumab dosed
every 6 months
28
teriparatide is given how and how often
SC daily
29
which osteoporosis treatment can cause hypERcalcemia
teraparatide, abaloparatide
30
bisphosphonate contraindication
hypOcalcemia, cannot sit upright for 30 min
31
a patient requires prevention of osteoporosis regimen. 60 yo female. Ca is 9 mg/dL and healthy. CrCl is 36 mL/min. the doctor wants to know which oral bisphosphonate to recommend?
alendronate (do not use if CrCl<35; risedronate and ibandronate <30)
32
boniva
ibandronate
33
fosamax
alendronate
34
actonel, altevia
risendronate
35
reclast
zoledronic acid
36
zolendroic acid contraindications
hypOcalcemia, CrCl<35
37
which injectable bisphosphonate takes the longest to administer
zoledronic acid (15 min vs boniva which is 15-30 sec)
38
risendronate can be given how often in females
daily, weekly, or monthly
39
risedronate can be given how often in males
weekly
40
boniva PO is given how often
monthly
41
Boniva IV injection is given how often
every 3 months
42
Reclast for treatment is given how often
yearly
43
reclast is given how often
every 2 years
44
what bisphosphonate should be recommended in a patient with esophagitis
injectables (boniva or reclast)
45
raloxifene MOA
SERM, dec bone resorption
46
duavee can only be used in female patients with
a uterus
47
evista contraindications
VTE, pregnancy
48
duavee contraindications
VTE, pregnancy, uterine bleeding, breast cancer
49
calcitonin MOA
inhibit bone resorption by osteoclasts
50
administration route for calcitonin
nasal spray, SC, IM
51
calcitonin has a warning against hypersensitivity to
salmon-derived products
52
teriparatide is indicated when
very high risk of fracture
53
denosumab binds to
RANKL
54
prolia
denosumab
55
denosumab is indicated when
very high risk of fracture
56
denosumab is contraindiacted in
pregnancy (bc antibody) and hypOcalcemia
57
denosumab may dec levels of which chemical
PO4
58
romosozumab duration of therapy
12 months
59
which bisphosphonate is administered as an oral solution
binosto
60
parathyroid hormones may cause
dizziness, orthostasis
61
astroglide is used as
lubricant for dyspareunia
62
local estrogen products
estrace, estring, vagifem, premarin
63
estradiol patch brand names
alora, climara, vivelle dot
64
a patient with dementia should not use
systemic hormone therapies
65
vivelle dot is applied how often
twice weekly
66
climara is applide how often
once weekly
67
medroxyprogesterone brand
provera
68
micronized progesterone brand
prometrium
69
where should estrogen progestin patch be applied
lower abdomen
70
what natural products may help with menopause
black cohosh, evening primrose oil, red clover, soy
71
non-hormonal drug used to treat menopause
paroxetine
72
ospemifene is indicated in
dyspareunia
73
which medications can lower testosterone
opioids, chemotherapy, cimetidine, spironolactone
74
testosterone side effects
baldness, acne, gynecomastia
75
what is the least preferred testosterone formulation
injection (painful, inc hematocrit)
76
boxed warning for topical testosterone
secondary exposure causing early virilization

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