Drug Class - Bone Resorption Inhibitors

Front 1

Two groups of bone resorption inhibitors?

Back 1

biphosphonates
selective estrogen receptor
modulators

Front 2

Name 7 biphosphonates?

Back 2

alendronate
etidronate
ibandronate
pamidronate
risedronate
tiludronate
zoledronic acid

Front 3

Name 1 selective estrogen receptor modulators?

Back 3

raloxifene

Front 4

What are the general uses of bone resorption inhibitors?

Back 4

primarily used to treat and prevent osteoporosis due to other causes including:
corticosteroid therapy
treatment of Paget's disease
of the bone
management of hypercalcemia

Front 5

Biphosphonates:
alendronate
etidronate
risedronate
tilundronate

these inhibit resorption of bone by inhibiting 1_______ _______ _____ and 2____ ____.

Back 5

1. hydroxyapatite crystal dissolution
2. osteoclast activity

Front 6

Which agent binds to estrogen receptors, producing estrogen-like effects on bone including decreased bone resorption and decreased bone turnover.

Back 6

Raloxifene

Front 7

Contraindications?

Back 7

hypersensitivity
hypocalcemia

Front 8

Raloxifene should not be used in women with child-bearing potential or a history of _______ disease.

Back 8

thromboembolic disease

Front 9

Use cautiously in patients with _____ impairment; some agents should be avoided in moderate to severe _____ impairment.

Back 9

renal
renal

Front 10

______ supplements decrease absorption of biphosphonates.

Back 10

calcium

Front 11

Tilundronate's effects may be altered by aspirin or other ______.

Back 11

NSAIDs

Front 12

Aspirin may increase _______ adverse reactions with alendronate.

Back 12

GI

Front 13

Cholestyramine (increases, decreases) absorption of raloxifene (concurrent use contraindicated)

Back 13

decreases

Front 14

What assessments should be done?

Back 14

low bone density before and
during therapy
symptoms of Paget's disease
(bone pain, headache,
decreased visual and
auditory acuity, increased
skull size)

Front 15

What are the symptoms of Paget's disease?

Back 15

bone pain
headache
decreased visual
auditory acuity
increased skull size

Front 16

What are lab test considerations?

Back 16

monitor serum calcium in patients with osteoporosis...monitor alkaline phosphatase in patients with Paget's disease

Front 17

What serum levels should be monitored in patients with osteoporosis?

Back 17

calcium

Front 18

What serum levels should be monitored in patients with Paget's disease?

Back 18

alkaline phosphatase

Front 19

List 2 potential nursing diagnoses?

Back 19

Injury, risk for
Knowledge, deficient, related
to disease processes and
medication regimen

Front 20

Instruct patient to take
medication exactly as
directed
Encourage patient to partici-
pate in regular exercise
and to modify behaviors
that increase the risk of
______.

Back 20

osteoporosis

Front 21

EVALUATION:
Clinical response to therapy can be evaluated by?
Prevention of or decrease in the progression of _____ in postmenopausal women. Decrease in the progression of _____ disease.

Back 21

osteoporosis
Paget's