Osteoporosis Flashcards
(16 cards)
How much daily calcium is recommended for men and women?
100mg men 50-70 y.o
or
1200mg/day for women >51 and men >71
When is the bone density test recommended?
F > 65 and M >70
post menopausal with family history of OP, smoking, underweight, steroid use
What is the T score and values.
> -1 = mormal
-1 to -2.5 - osteopenia
< -2.5 - osteoporosis
Raloxifem
Brand
MOA
Dose
ADE
two common drug interactions
Evista
SERM
60mg QD
VTE, hot flashes
Cholestyramine can decrease evista absorption and evista can decrease levothyroxine absorption
Counseling points for bisphosphonates including ADE
Must stay upright for at list 30 minutes, take in AM, and don’t eat for 30-60min
Take supplemental 1200mg/d calcium and 800-2000u VitD
Not for CrCl <30
Hypocalcemia, osteonecrosis of the jaw
Which bisphosphonates are IV?
Ibandronate - boniva
Zoledronic acid -Reclast and zometa
Pamidronate - aredia
What is the difference between reclast and zometa?
Reclast is IV 5mg ONCE A YEAR
Zometa is IV 4mg every 3-4 WEEKS and is not for osteoporosis - its for hypercalcemia of malignancy
What is the only bisphosphonate that you take with food?
Risendronate DR - Atelvia
Denosumab
Brand
MOA
ROA
Dose
Contraindications
Prolia and Xgeva
Inhibits RANKL
SubQ -
Prolia- 60mg every 6 months
Xgeva - 120mg Q4 weeks
Hypocalcemia
Teriparatide
Brand
MOA
Indications
Dose
Lomitation
Forteo
Recombinant parathyroid hormone
Post menopausal women and men with o=OP
20mcg QD SQ
Can only use for TWO years
What is NOT a first line agent for OP tx in women?
What is first line?
What if NPO?
What if renal impairment?
Estrogen
Bisphosphonate
Zoledronic acid, denosumab, ibandronate
Denosumab
estradioal patches
Which ones are twice weekly and which are once weekle=y?
Twice weekly - Vivelle and Alora
Once weekly - Menostar, Climara
First line for men with OP?
Bisphosphonates
What are three FDA approved treatments for bone metastases?
Zoledronic acid - Zometa
Pamidronate - Aredia
Denosumab - Xgeva
Abaloparatide
Brand
MOA
Dose
Limitation
Box warning
Tymlos
PTH analog
80mcg SUB QD
Max 2 years
Osteosarcoma (bone cancer)
Romosozumab
Brand
MOA
Dose
Indication
Evenity
Sclerostin inhibitor
210mg QD month x 12 doses by a doctor
Tx of OP in postmenopausal women
