Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
45 Cards in this Set
- Front
- Back
|
What are the Four Strongest factors that predict fracture risk?
|
Low peripheral bone mineral Density (BMD)
Prior fragility fracture Advanced Age Family History of Osteoporosis |
|
|
This injectable has a Black Box warning of sagnificant loss of BMD
|
Depo-Prevera
(medroxyprogesterone) |
|
|
Name a couple drugs that may lead to Osteoporosis
|
Phenobarbital and Phenytoin :interfere with Vitamin D metabolism
Systemic Glucocorticoids (Exceding > 5mg of prednisone daily) b/c of decreased Ca absorption and dec estrogen and testosterone |
|
|
what is the drug of choice for glucocorticoid induced osteoporosis
|
Bisphosphonates
|
|
|
What is the gold standard assessment method for Osteoporosis?
|
Dual Energy x-ray absorptiometry
|
|
|
This score is the number of standard deviations from the mean BMD of a healthy young female
|
T-score
|
|
|
This score compares bone mass to a group matched for age, sex, weight, and race
|
Z-Score
|
|
|
Who are candidates for BMD assessments?
|
ALL women >65
postmenopausal women <65 with 1 or more risk facors postmenopausal women with fractures without severe trauma Men at high risk |
|
|
What is the diagnosis for a BMD calue within 1 SD of the young adult mean
|
Normal
|
|
|
What is the diagnosis for a BMD value between -1 SD and -2.5 SD below the young adult mean
|
Osteopenia
|
|
|
What is the diagnosis for BMD value at least -2.5 SD below the young adult mean?
|
OSTEOPOROSIS!!
|
|
|
C-terminal and N-terminal telopeptides are biomarkers of what?
|
bone resorption
|
|
|
Byproducts of collagen degredation such as urine deoxypyridinoline are biomarkers of what?
|
Bone resorption
|
|
|
Bone-specific alkaline phosphatase and osteocalcin are biomarkers of what
|
Bone Formation
|
|
|
How would you assess a patient with a Z score of <-2?
|
Work-up for secondary osteoporosis:
PTH TSH CBC..etc |
|
|
this form of calcium must be taken with food and can cause constipation
|
Ca carbonate
|
|
|
this for of calcium has good absorption even in an acidic environment
|
callcium citrate
|
|
|
Bisphosphosponates are pregnancy category __
|
C
|
|
|
what is the MOA of Bisphosphonates?
|
supress osteoclast mediated bone resorption
|
|
|
How must Bisphosphonates be administered?
|
30-60min before first food
drink w 6-8 oz of water avoid gastroesophageal irritation by standing or sitting upward for at least 30 min |
|
|
what are classic SE for Bisphosphonates?
|
Abdominal pain, dyspepsia,
|
|
|
In what circumstances would you NOT consider using a bisphosphonate?
|
CrCl <35ml/min
Active Bleeding Ulcer GERD Inability to sit up for 30 min |
|
|
HRT may increase the risk of ________
|
Cardiovascular events
|
|
|
T/F Conjugated estrogens have a bone sparing effect when combined with calcium and Vit D and can increase BMD
|
TRUE
|
|
|
T/F studies have proven the use of Fosomax and conjugated estrogens combined unsafe
|
FALSE
|
|
|
HRT is Pregnancy Cetegory __
|
X
|
|
|
T/F HRT must be taken on an empty stomach
|
FALSE
|
|
|
what are the SE of HRT?
BBW |
edema, leg cramps, migraine
BBW for increased risk of MI, stroke, DVT/PE in postmenopausal women 50-79 |
|
|
When would you not administer HRT to a patient?
|
CrCl<35
Active DVT/PE Pregnant Arterial Vascular Disease Risk |
|
|
SERM is pregnancy category ___
|
X
|
|
|
what is the MOA of teriperatide (forteo)?
|
stimulates new bone formation of trabecular and cortical bone. stimulates osteoblast activity over osteoclast activity
|
|
|
Teriperatide SE and BBW
|
BBW: Osteosarcoma in rats
Orthostatic hypotension after first dose (take at night) |
|
|
What would you recommend to a male patient with opteoporosis who can not take Bisphosphonates?
|
Teriperatide
|
|
|
What would you recommend for a woman who can not take bisphosphonates?
|
SERM
If cant take SERM, give Teriperatide (Forteo) |
|
|
Fosomax dose for Prevention
|
35mg once weekly
|
|
|
Fosamax treatment dose
|
70mg once a week or 10mg once daily
|
|
|
Fosamax dose for Tx glucocorticoid Osteoporosis
|
5mg QD
Except 10mg QD for postmenopausal women NOT on HRT |
|
|
Actonel dose for Tx osteoporosis in men
|
35mg once weekly
|
|
|
Actonel dose for Tx and prevention of Glucocorticoid Osteoporosis
|
5mg QD
|
|
|
How much elemental Calcium in calcium Carbonate gets absorbed?
|
40%
|
|
|
How much elemental calcium gets absorbed in Calcium Citrate?
|
24%
|
|
|
Up to how much Vitamin D is recommended daily?
|
2000mg daily
|
|
|
what is the recommended Calcium in an adult <50?
|
1000mg
|
|
|
What is the recommended Calcium intake in adults >50?
|
1200mg daily
|
|
|
what is the recommended Vitamin D intake in adults <50?
|
400-800IU
|
