30 Questions
What are common side effects of calcium supplements?
Abdominal distention and constipation
What is the recommended action after taking alendronate?
Report adverse effects to the health care provider immediately
When is it recommended to take a calcium supplement with vitamin D?
With meals or with a beverage high in vitamin C
Which drug is used to treat osteoporosis in postmenopausal women at high risk of fracture?
Denosumab (Prolia)
What does meta-analysis findings demonstrate about vitamin D in primary prevention of fractures?
Vitamin D taken alone is not effective
What is the primary function of calcitonin in hypercalcemia?
Inhibit bone resorption
In addition to calcium, what other supplement reduces the risk of fractures in vitamin D deficient patients?
Vitamin D
Which drug is administered subcutaneously at 6-month intervals?
Denosumab (Prolia)
What is the recommended posture for a person after taking alendronate?
Sitting upright in a chair
What type of drugs should calcium and vitamin D be taken as supplements to?
Drugs prescribed to treat osteoporosis
What type of therapy is no longer recommended, but synthetic human PTH analogues are used in patients with advanced osteoporosis or who are treatment resistant?
Salmon egg based PTH
What is the primary adverse effect of bisphosphonates?
Nausea and vomiting
What is a key consideration when administering IV calcium preparations?
Administer IV calcium preparations slowly to avoid dysrhythmias and hypotension
What is a good source of dietary calcium?
Milk, yogurt, and various vegetables
Why is treatment of hypomagnesemia essential before treating hypocalcemia?
Hypomagnesemia can lead to hypocalcemia
What should be done to manage hypocalcemia?
Managing the underlying cause or preventing recurrence
What can excessive vitamin D use lead to?
Hypervitaminosis D and hypercalcemia
Why should calcium supplements be avoided with certain medications and foods?
To prevent interference with the absorption of calcium
What are some potential consequences of vitamin D excess?
Kidney stones, irreversible kidney damage, and muscle and bone weakness
What is a contraindication to vitamin D?
Hypercalcemia
What is a potential risk for patients on long-term alendronate therapy?
Esophagitis, dysphagia, esophageal ulcers, and atypical femur fracture
What must be done to prevent interactions and ensure proper administration of alendronate?
It must be taken with a full glass of water at least 30 minutes before breakfast
What are bisphosphonates like alendronate used to prevent and treat?
Osteoporosis, Paget's disease, and glucocorticoid-induced osteoporosis
What are some patient teaching guidelines for vitamin D?
Emphasize approved use, recognizing early symptoms of intoxication, and understanding dietary sources and sunlight exposure
What is the recommended posture for a person after taking calcium medications?
Sitting upright
Where does the absorption of calcium primarily occur?
Small intestine
What are the rare side effects associated with calcium preparations?
Osteonecrosis of the jaw and subtrochanteric fractures
Which population is hypocalcemia uncommon in?
Older adults
What is the essential use of IV calcium preparations?
Treatment of acute, severe hypocalcemia
What may patients with renal impairment use calcium acetate for?
To prevent or treat hyperphosphatemia
Study Notes
Calcium Preparations and Their Clinical Implications
- Medications must be taken on an empty stomach, with water, and the person must sit upright for at least 30 minutes after ingestion
- Risks of using these medications include gastritis, ulceration, and GI bleeding
- Rare side effects include osteonecrosis of the jaw and subtrochanteric fractures
- Calcium is available in different forms and routes of administration
- Absorption of calcium occurs in the small intestine, where approximately one third of the amount consumed is absorbed
- Oral and IV calcium preparations help maintain normal calcium levels
- Oral calcium provides relief from symptoms of acid indigestion and heartburn, decreases bone loss, and fractures, especially in women
- IV calcium is essential for the treatment of acute, severe hypocalcemia
- Hypocalcemia is uncommon in older adults, but calcium deficiency commonly occurs due to dietary deficiencies and impaired absorption
- Patients with renal impairment may use calcium acetate to prevent or treat hyperphosphatemia
- Adverse effects of hypercalcemia include GI effects, central nervous system effects, cardiac effects, weakness, and decreased tone in muscles
- Various medications and foods interact with calcium supplements, increasing or decreasing their effects
Test your knowledge about calcium preparations and their clinical implications with this quiz. Explore the different forms and routes of administration, absorption, risks, benefits, and interactions of calcium medications. Assess your understanding of the management and treatment of hypocalcemia and hypercalcemia, as well as the impact of calcium deficiency in older adults and patients with renal impairment.
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