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47 Cards in this Set
- Front
- Back
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risk factors for fracture (age < 50) |
-fragility fractures -use of high-risk medications -hypogonadism -malabsorption syndromes -chronic inflammatory conditions -perimary hyperparathyroidism -other disorders strongly associated w rapid bone loss or fractures |
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risk factors for fracture (age 50-64) |
-fragility fx after age 40 -prolonged use of glucocorticoids or other high risk medications -parental hip fx -vertebral fx or osteopenia identified on radiography -high alcohol intake or current smoking -low body weight (<60kg) or major weight loss (>10% of body weight at age 25) -other disorders strongly associated w osteoporosis |
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dietary sources of calcium |
milk cheese yogurt ice cream tofu with calcium sulphate white beans almonds sardines salmon rice or soy beverage fortified orange juice broccoli orange |
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calcium in 1 cup milk |
300mg |
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calcium in 50g hard cheese |
370mg |
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calcium in 1/4 cup almond |
90mg |
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calcium in 1 med orange |
50mg |
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calcium in 1/2 cup fortified orange juice |
185mg |
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how much calcium in Tums regular |
200mg elemental per |
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how much calcium in caltrate |
600mg elemental |
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how much calcium in citracal |
200mg elemental |
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how much calcium in citracal + D |
315mg elemental |
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how much vit D in caltrate600 + D |
800 IU |
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how much vit D in caltrate plus |
800 IU |
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how much vit D in citracal + D |
200 IU |
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health canada calcium requirements: 51-70 y/o |
males: 1000mg females: 1200mg |
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health canada calcium requirements: > 70 y/o |
1200mg |
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health canada calcium requirements pregnancy/lactation |
14-18 y/o: 1300mg 16-50 y/o: 1000mg |
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health canada vit D requirements: 9-70 y/o |
600 IU |
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health canada vit D requirements > 70 y/o |
800 IU |
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health canada vit D requirements pregnancy/lactation |
600 IU |
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vit D: canadian pediatric recommendations |
premature infants: -200 IU/kg/d -max 400 IU/d infants first year: -400 IU/d -increase to 800IU/d from oct-april for those living north of 55th parallel (edmonton) infants and children should be exposed to sunlight for short periods (15min/d) suggest considering 2000IU daily to pregnant and lactating women |
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dietary sources of vit D |
milk rice or soy beverage fortified orange juice egg yolk sockeye salmon, canned atlantic sardines pacific sardines tuna |
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vit D in 1 cup milk |
100 IU
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vit D in 1/2 cup fortified orange juice |
50 IU |
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vit D in 75g sockeye salmone |
585IU |
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vit D in 1 egg yolk |
25 IU |
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calcium carbonate % elemental calcium |
40% |
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calcium citrate % elemental calcium |
21% |
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calcium gluconate % elemental calcium |
9% |
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calcium carbonate pros |
inexpensive contains highest amount of elemental calcium well absorbed by most of the popn to enhance abs: -take w food (comparable abs to calcium citrate) -take in divided doses (can only abs 500mg/dose) |
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calcium carbonate cons |
SE: -flatulence, bloating, constipation |
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calcium citrate pros |
-pH independent -less carbon dioxide production recommended for pts w: -achlorhydria -kidney stones -intolerable gas w carbonate |
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calcium citrate cons |
more expensive than carbonate in general avoid in chronic renal failure -binds albumin in dialysis soln |
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coral calcium |
contains: calcium carbonate, magnesium, trace amounts of other minerals -claimed to be from coral reefs marketed as: -a calcium w superior absorption -a panacea for Alzehimer's, cancer, diabetes, fibromyalgia -claimed that low body pH causes these conditions and that coral calcium increases pH no benefit |
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milk-alkali syndrome |
-historically occurred w ingestion of large amounts of calcium and an absorbable alkali (eg sodium bicarbonate) leading to hypercalcemia today more likely w inappropriate high doses of calcium carbonate - >4000mg elemental calcium/d -cases have occured w 1000-1500mg elemental calcium/d -recent resurgence in geriatric popn usual presentation: hypercalcemia, metabolic alkalosis, imparied renal fxn -sn/sx hypercalcemia: fatigue, depression, mental status changes, N/V/C, urinary frequency, ECG changes, arrhythmias large amounts of milk or dairy products are not necessary for this condition to develop |
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kidney stones |
4 types: calcium, uric acid, struvite, cysteine most kidney stones made of caclium oxalate -precipitation of calcium oxalate crystals in the urine -increased oxalate likely cause of kidney stones dietary calcium binds oxalates in the GIT -limits their abs and prevents their precipitation in the kidney low calcium diet increases oxalate in the urine |
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advise kidney stone pts to: |
-limit sources of oxalate (beet greens, rhubarb, sorrel, nuts, berries, spinach, chocolate) -continue w calcium intake (dietary more protective?) -calcium citrate may have protective effect |
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pts who may be at risk for lead toxicity |
renal failure pts using large amounts of calcium acetate |
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lead contamination |
lead is a natural component in many foods and supplements a serving of raisins, grapes, berries, wine, or leafy greens contains more lead than a typical calcium supplement |
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lead content in calcium supplements |
per 1500mg elemental calcium/d: -caltrate > 3mcg -nature made (oyster shell) 1.95mcg -oscal 1.74mcg -Tums below level of detection |
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sx of calcium toxicity |
-increased thirst -urinary frequency -nocturia -anorexia -nausea -lightheadedness -mental confusion |
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foods/medications that may interact w calcium |
-Phytates (bran, metamucil, soybeans, seeds) -some Abx (quinolones, tetracyclines) -thiazide diuretics -bisphosphonates -L-thyroxine -iron |
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magnesium benefit |
has a role in bone and teeth formation possible benefits of concurrent use w calcium -laxative effect > 350mg -concurrent ingestion w calcium does not seem to affect abs or either mineral |
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sources of magnesium |
-whole grains -green leafy vegetables -nuts -seafood |
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magnesium DRI |
320-420mg |
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vit K recommendations |
-not recommended for prevention of post-menopausal osteoporosis -not recommended for tx of postmenopausal osteoporosis -not recommended for use in men or premenopausal women |
