Osteoperosis

Question 1

Calcium supplements

Answer 1

-differ in the amount of calcium they contain

Question 2

Calcium acetate 
Calcium citrate
Calcium lactate 
Calcium carbonate 
Calcium glubionate
Tricalcium phosphate 
Calcium chloride *
Calcium gluconate**

Answer 2

Calcium supplements

Question 3

Calcium chloride is given how?

Answer 3

IV only

Question 4

Calcium gluconate is given how?

Answer 4

IV and PO

Question 5

Ergocalciferol (liver met)
Dihydrotachysterol (doesn't require renal met)
Cholecalciferol (liver met)
Doxercalciferol
Calcifedol
Pericalcitol
Calcitrol

Answer 5

Vitamin D analogs

Question 6

Alendronate
Etidronate
Risedronate
Zoledronate
Ibandronate
Pamidronate
Tiludronate

Answer 6

Bisphosphonates

Question 7

Raloxifene (evista)

Answer 7

Other anti osteoporosis/Ca drug

• selective estrogen receptor modulator
• mimics estrogen effect on bone, lipids and blood clotting
• blocks effects on endometrium and boobs
• VTE risk
• cause hot flashes

Question 8

Calcium supplements * given with vitamin D only way they are absorbed

Answer 8

• limited absorption (Max 600)
• risk of hypercalcemia
• GI toxicity (n/v, constipation)
• CNS toxicity (lethargy)
• drug inx; Chelation- bind to other drugs

Question 9

Bisphosphonates

• work well
• not all are approved to treat OP

Answer 9

• work in bone matrix/ become part of the bone
• decrease osteoclast activity
• low bioavailability
• take on empty stomach
• avoid with calcium and antacids

Question 10

Bisphosphonates AEs

Answer 10

Musculoskeletal pain, ONJ, esophageal cancer, renal toxicity

• atypical fracture risk
• esophagitis risk

Question 11

Bisphosphonates Patient Education

Answer 11

• take on empty stomach
• take with big glass of water
• remain upright for 30 min
• avoid taking calcium and antacids
• tell dentist if taking these, risk of ONJ
• risk of atypical fractures