ZOLEDRONIC ACID

Question 1

what is Zoledronic acid

Answer 1

a bisphosphonate

Question 2

how does it work?

Answer 2

adsorbed onto hydroxyapatite crystals in bone, slows the rate of growth and dissolution therefore reducing turnover

Question 3

dose if renal impairment?

Answer 3

avoid if <30ml/min

Question 4

who cannot receive zolendronic acid?

Answer 4

hepatic impairment 
atypical femoral fractures 
cardiac disease- fluid overload
patients on other medication affecting renal function 
dental disease

Question 5

what should be monitored?

Answer 5

correct calcium metabolism disturbance before starting
monitor serum electrolytes
monitor renal function in high risk patients

Question 6

can you give in pregnancy and BF

Answer 6

C/I in women of child bearing age

avoid in BF

Question 7

what must patients look out for?

Answer 7

hip, thigh or groin pain during treatment: atypical femoral fractures
osteonecrosis of the daw: dental mobility, pain, non healing sores, discharge

Question 8

risk factors for osteonecrosis?

Answer 8

potency, dose, duration, smoking, dental disease,

Question 9

3 safety concerns with this drug

Answer 9

atypical femoral fractures, osteonecrosis of 2) the jaw 3)the auditory canal

Question 10

risk factors for osteonecrosis of the ear canal

Answer 10

steroid use, chemotherapy, infection, ear operation, cotton bud use