Flashcards in Parathyroid Disease Deck (25):
1
what is the function of PTH in the bone?
inc. osteoclast activity
2
what is the function of PTH in the kidney?
holds onto Ca
wastes phosphorus and bicarb
stimulated synthesis of vitamin D (increasing absorption of Ca in the gut)
3
what is the pathway of vitamin D/
1. dietary D2, D3 or D3 from sunlight
2. liver turns D3 into 25 OH vitamin D
3. kidney covnerts 25 OH to 1, 25 OH vitamin D (active form)
4
which vitamin D level do we test for?
25 hydroxyvitamin D
5
what is the daily recommended dose of Ca (including dietary)?
1000-1200mg
6
what is the daily recommended dose of vitamin d?
2000IU
7
what are common side effects of bisphosphonates?
GI upset
esophagitis/cancer
gastric ulcer
atypical chalk-stick femoral fractures
BRONJ (necrosis of the jaw)
hypercalcemia
8
how do bisphosphonates need to be taken?
first thing in the morning with a full glass of water and don't eat for an hour
9
what are contraindications of bisphosphonates?
esophageal dz
inability to sit to stand upright
hypocalcemia
10
what are bisphosphonate agents?
risedronate (actonel) qweek or qmonth
alendronate (fosamax) qday or qweek
ibandronate (boniva) qmonth or q3months (not as much fx reduction data)
11
what is zolendronic acid (reclast) used for?
osteoporosis
q12 months
$$$$
12
what are contraindications of reclast?
CrCl ,35
BRONJ
13
over what time frame would forteo be given?
2 yr course
14
what are contraindications of forteo?
paget's dz
bone mets
hypercalcemia
15
what type of pt should receive forteo?
young pt
hypogonadal osteoporosis in male
16
what type of fractures do SERMS reduce more than others?
vert (40%) over non vert
17
which osteoporosis drug reduces risk of breast cancer?
evista (raloxifene)
18
what risk does evista increase?
DVT and hot flashes
19
what are the major side effects of prolia?
BRONJ
hypocalcemia
serious infections
dermatologic rxns
20
when is ERT/HRT therapy recommended?
prevention of postmenopausal osteoporosis (use conservatively and get a good breast ca hx)
21
how does estrogen impact bone?
inhibits osteoclasts
22
when would you give a pt calcitriol?
vitamin D deficiency with kidney or renal dz
23
what is the most common cause of hypoparathyroidism?
post thyroid or parathyroid surgery
24
what does Mg do to PTH levels?
lowers them by preventing PTH secretion
25