Calcium/Osteoporosis Flashcards
Vitamin D
PRIMARY FUNCTION: cofactor with PTH to increase GI absorption of Calcium
- essential for bone health
- prevention/treatment of postmenopausal osteoporosis and renal osteodystrophy
- decreased Vit D will increase risk for diseases (cancers, infections, asthma, heart disease, dementia, diabetes, chronic pain syndromes, and autoimmune disorders)
- two forms = D2 and D3 (active form)
- Increases PTH mediated osteoCLAST maturation
-High risk deficiency in:
Children, breast fed infants in mothers, older adults, people with limited sun exposure, dark skinned, fat malabsorption syndromes, obese, gastric bypass patients (quick emptying of stomach = decrease of vit D)
Vit D primary food sources
sunlight fatty fish (salmon, swordfish, tuna, mackerel, cod liver oil) milk (fortified) infant formula breakfast cereals orange juice yogurts
Vit D dosage
400-800 mg/day (more if deficient)
Calcium needed for the functioning of?
- bones
- neuro-muscular system
- cardiac system
Dietary sources of Calcium
- milk
- broccoli
- spinach
- fortified foods – orange juice and cereals
Calcium intake
> 70 y/o need more vitamin D & Calcium
- children need more calcium for bone growth/development
Calcium salts
- Calcium acetate/PhosLo (least absorbed)
- Calcium carbonate/Tums, Rolaids (well absorbed)
- Calcium citrate/Citracal (highest absorption)
Calcium salts for Cardiac Conduction:
- Ca gluconate/Cal-G (used most often) (IV)
- Ca Lactate/ Cal-Lac
- Ca Chloride (Given IV)
Low calcium contributes to
osteoporosis
Low vitamin D contributes to
increase risk for disease
Calcitonin
- produced by Thyroid gland = REDUCE calcium levels
- rarely given
- a hormone that can be given as a medication
- 8.5 - 10.5 normal ca levels
- does NOT affect calcium absorption in gut
Calcitonin-Salmon (Miacalcin, Fortical)
-form of calcitonin derived from salmon similar to human calcitonin
MOA:
- decrease bone resorption by inhibiting activity of osteoCLASTS
- increase calcium excretion by inhibiting renal tubule resorption
INDICATIONS:
- treatment of postmenopausal osteoporosis
- NOT prevention
- Paget’s disease
ROUTE: nasal spray or injection; 1 nostril/day (alternate - don’t forget which nostril was sprayed last)
ADR:
- VERY SAFE
- Nausea diminshes overtime
- flushing of face and hands
- may not work after a year due to antibody development
Biphosphonate prototype Drug
Alendronate (Fosamax)
Alendronate (Fosamax)
MOA:
- suppress bone resorption by decreasing number AND activity of osteoCLASTS
INDICATIONS:
- osteoporosis in POSTmenopausal women and in men.
- glucoccorticoid-induced osteoporosis
- Paget’s disease
ADR:
- esophagitis
- atypical femur fraction
- occular inflammation
- osteonecrosis of jaw
ROUTE: PO
Alendronate (Fosamax) administration
- full glass of water in AM
- before eating food/fluids to maximize bioavailability
- wait 30-60 mins to consume food/fluid
- given daily, weekly, or monthly formulations
- Must increase WB exercises*
- drink plenty of water to prevent cancer*
- ** if they can’t sit up they CAN’T take medicine***
ADR of Alendronate that can lead to?
Barret’s esophagitis (from esophagitis)
