osteo

Question 1

risedronate po dosage

Answer 1

35 mg per week

Question 2

administration instructions for po bisph

Answer 2

30min before breakfast with a full glass of water. maintain upright for at least 30 mins

Question 3

alendronate po dosage

Answer 3

70 mg per week

Question 4

contraindications for po bisp

Answer 4

crcl <30ml/min
hypocalcemia
oesophageal/gastric/gi abnormalities
inability to sit upright ≥30 mins
aspiration risk (eg difficulty swallowing liquids)

Question 5

se of iv bisp

Answer 5

Flu-like symptoms, worsened renal function

Question 6

se of po bisp

Answer 6

Nausea, ab pain, heartburn, upper GI irritation

Question 7

side effects of bisphosphonates /mabs

Answer 7

ONJ, atypical femoral fracture, muscle pain

Question 8

how long can you take po bisph

Answer 8

5 yr

Question 9

how long can you take iv bisph

Answer 9

3 yr

Question 10

how often to repeat BMD

Answer 10

every 2 years

Question 11

how much serum 25(OH) vit d should be present before initiating therapy

Answer 11

≥ 20-30 ng/ml

Question 12

zoledronic acid (iv) dosing

Answer 12

5 mg per year as 30 min infusion

Question 13

zoledronic acid (iv) ci in

Answer 13

crcl <35 ml/min
hypocalcaemia

Question 14

drugs ci in hypocalcaemia

Answer 14

iv, po bisphosphonates
denosumab
calcitonins

Question 15

drugs causing hypercalcaemia

Answer 15

teriparatide

Question 16

first line for osteo

Answer 16

po bisphosphonates

Question 17

how long can you use romosozumab for

Answer 17

max 1 year

Question 18

ci for romosozumab

Answer 18

hx of cvs event/stroke, uncorrected hypocalcemia

Question 19

administration of romo

Answer 19

once a month

Question 20

administration of denosumab + concurrent suppl?

Answer 20

once every 6 months, 1000mg Ca + 400 IU Vit D (OD)

Question 21

teriparatide sc

Answer 21

20 mcg OD

Question 22

teriparatide ci in

Answer 22

crcl<30
any hx of bone issues: paget’s disease/ hx of bone radiation
hypercalcemia
severe renal impairment
pregnancy

Question 23

teriparatide se

Answer 23

serious calciphylaxis, postural hypotension, transient hypocalcemia

Question 24

teriparatide can treat for how long

Answer 24

max 2 years

Question 25

raloxifene po dosage

Answer 25

50mg OD

Question 26

raloxifene ci

Answer 26

crcl <30 hx/current VTE hepatic / severe renal impairment hx of breast cancer

Question 27

se of raloxifene

Answer 27

vte, stroke risk

Question 28

moa of romo

Answer 28

scelerostin inhibitor. Removes sclerostin inhibition of signalling pathway that regulates bone growth, increasing bone formation and decrease bone resorption

Question 29

moa of denosumab

Answer 29

rankl inhibitor, prevents development of osteoclasts

Question 30

moa of teriparatide

Answer 30

recombinant parathyroid hormone, stimulates new bone formation, increases bone strength

Question 31

raloxifene moa

Answer 31

selective estrogen receptor modulator, mimics effects of oestrogen to maintain bone density

Question 32

ibandronate po dosage

Answer 32

150mg per month

Question 33

raloxifene preferred in

Answer 33

women without hot flushes

Question 34

list 3 non pharm for osteo

Answer 34

exercises - weight bearing, muscle strengthening smoking cessation limit alcohol intake adequate calcium intake vit d supplementation

Question 35

medications inducing osteo

Answer 35

glucocorticoids immunosuppressants ASM GnRH agonists heparin chemotherapy thyroid hormones

Question 36

avoid concurrent administration of calcium with

Answer 36

ppi, fibre, iron, tetracyclines, FQLs, bisphosphonates, thyroid supplements

Question 37

osteopenia bmd

Answer 37

-1 to -2.4

Question 38

osteoporosis

Answer 38

-2.5 and worse

Question 39

examples of anabolic agents

Answer 39

PTH therapies - teriparatide sclerostin inhibitors - romo

Question 40

examples of antiresorptive agents

Answer 40

bisphosphonates

Question 41

moa bisph

Answer 41

increases osteoclast cell death, slowing bone loss

Question 42

what to screen for bisp before initiation

Answer 42

calcium, vit d deficiency

Question 43

se of denosumab

Answer 43

muscle, back, bone pain and aches NVD increased cholesterol hypocalcaemia cellulitis eczema

Question 44

ci of deno

Answer 44

hypocalcemia, pregnancy, crcl <10

Question 45

screen prior to deno

Answer 45

scr, 25 OH vitD

Question 46

denosumab do not discontinue because?

Answer 46

increased risk of spinal column fractures

Question 47

raloxifene preferred in

Answer 47

younger women or women whose menopausal sx require concurrent tx

Question 48

raloxifene se

Answer 48

increased risk of breast cancer, blood clots, stroke/vte, hot flushes

Question 49

calcitonin moa

Answer 49

reduces blood calcium, opposes effects of PTH, inhibiting osteoclastic bone resorption

Question 50

calcitonins ae

Answer 50

red streaks on skin, injection site rxn, warm feeling, redness

Question 51

calcitonins ci

Answer 51

hypersensitivity, hypocalcemia

Question 52

romosuzumab ae

Answer 52

MI/cvs/stroke hypocalcaemia