Osteoporosis Meds Flashcards
(13 cards)
For the osteoporosis chapter what gland are we examining?
FOR THIS CHAPTER, WE ARE ONLY LOOKING AT PARATHYROID GLAND
4 little glands on the back of the thyroid, which are about the size of a grain of rice.
Their job is to monitor calcium levels in the bones. If levels are too low or high, they release hormone to try and fix.
What is the role of calcium in maintaining homeostasis?
Calcium is critical to maintaining homeostasis.
Need adequate levels to transmit nerve impulses, prevent spasms, stability and movement, provide for blood coagulation and myocardial activity.
What role does parathyroid hormone play in the balance of calcium?
Parathyroid secretes parathyroid hormone (PTH) which stimulates osteoclasts, and accelerates bones resorption.
Increased serum calcium leads to slowed nerve conduction. Can present as chronic fatigue, trouble concentrating.
Stimulates GI absorption of Calcium
What role does Calcitonin and parathyroid hormone play in calcium balance?
Calcitonin is secreted by thyroid gland, stimulates bone deposition.
PTH and calcitonin influence three targets: bones, kidneys, and gastrointestinal tract
What is calcium metabolism in osteoporosis?
a. Normal calcium intake: absorption from GI tract deposition to bone (normal bone homeostasis: Deposition = resorption) resorption into bloodstream & to body.
b. Low calcium intake: No deposition from GI tract to bone (osteoporotic bone: resorption exceeds deposition; bone becomes fragile) excess resorption into bloodstream & to body.
What is Alendronate (biphosphonates) and how does it function?
Blocks bone resorption by inhibiting osteoclast activity, increases bone density.
Usually taken weekly, usually on Sunday?
Prevention and treatment of osteoporosis.
Caution with kidneys, excreted unchanged. Hypocalcemia (also one of side effects)
Does Alendronate have any adverse effects?
HA, N/V/D, GI irritation, metallic-taste perception, esophageal erosion, dental issues, femoral fx, myalgias, hypocalcemia
Separate from multivitamin. Avoid aspirin
Take with full glass of water on empty stomach, first thing in morning. Have to stay upright for 30 min. Want it to go straight down into the stomach. (can cause esophageal erosion)
What is Raloxifene?
Selective estrogen receptor modulator
Similar to estrogen, with less side effects. Doesn’t cause certain cancers.
Decreases bone resorption and increases bone density.
Does Raloxifene have any adverse effects and contraindications?
Adverse:hot flashes, migraine headache, flu-like symptoms; endometrial disorder, breast pain, vaginal bleeding;=related to menopause
Pregnancy category X
Contraindications=history of venous thromboembolism
What is Calcitonin (from salmon) and how does it work?
Increases bone density by inhibiting bone resorption.
Opposes effects of PTH
Given nasal spray or SQ (skin test first)
Nasal spray= no side effects.
Emergency treatment of hypercalcemia
Contraindications: Pregnancy and lactation, allergy to salmon or fish
Adverse: Nausea Vomiting, Flushing, Hypocalcemia
What is Calcitriol (Vitamin D)?
Management of hypocalcemia (helps absorb calcium)
regulates the absorption of calcium and phosphate, increasing serum Calcium level
Caution: P & L, renal stones
Adverse Effects: H/A, weakness, N/V, constipation
What is the role of the nurse in Vitamin D therapy?
Lots of education. Can’t take with cholestyramine (have to wait hour before or hour after)
Monitor Liver and renal function
Monitor Magnesium, Calcium, and Phosphate levels
What do you assess when working with a patient receiving supplemental calcium therapy?
Assess for signs and symptoms of hypercalcemia
-Drowsiness, lethargy, weakness, headache,
Anorexia, nausea, vomiting, thirst, and increased urination
Assess for signs and symptoms of hypocalcemia?
-facial twitching, muscle spasms, paresthesias, and seizures
