Podcast
Questions and Answers
Denosumab is prescribed to a postmenopausal client for osteoporosis. What is the primary mechanism of action of denosumab?
Denosumab is prescribed to a postmenopausal client for osteoporosis. What is the primary mechanism of action of denosumab?
- Stimulating osteoblast formation to increase bone density.
- Inhibiting osteoclast activity by binding to RANKL. (correct)
- Directly depositing calcium into the bone matrix.
- Increasing estrogen production to promote bone health.
What is a crucial intervention that needs to be addressed before initiating denosumab therapy?
What is a crucial intervention that needs to be addressed before initiating denosumab therapy?
- Checking liver enzyme levels.
- Resolving pre-existing hypocalcemia. (correct)
- Initiating physical therapy.
- Administering a bisphosphonate.
A client taking denosumab reports muscle cramps and tingling in their fingers. Which adverse effect should the nurse suspect?
A client taking denosumab reports muscle cramps and tingling in their fingers. Which adverse effect should the nurse suspect?
- Hypercalcemia
- Hypernatremia
- Hypokalemia
- Hypocalcemia (correct)
Why is it important to advise clients taking denosumab to practice good oral hygiene and inform their dentist about their medication?
Why is it important to advise clients taking denosumab to practice good oral hygiene and inform their dentist about their medication?
A nurse is preparing to administer denosumab. What is the correct route and frequency of administration?
A nurse is preparing to administer denosumab. What is the correct route and frequency of administration?
Denosumab is contraindicated in clients with:
Denosumab is contraindicated in clients with:
A client with severe kidney disease is prescribed denosumab. What modification to the standard protocol is most likely?
A client with severe kidney disease is prescribed denosumab. What modification to the standard protocol is most likely?
Which concurrent medication would raise concern when prescribed with denosumab?
Which concurrent medication would raise concern when prescribed with denosumab?
Flashcards
Denosumab
Denosumab
A monoclonal antibody against RANKL used to treat osteoporosis and reduce fracture risk.
Bone Resorption Inhibitors
Bone Resorption Inhibitors
Medications that reduce the activity of osteoclasts, inhibiting bone resorption.
RANKL
RANKL
A protein that activates osteoclasts, which break down bone tissue.
Hypocalcemia
Hypocalcemia
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Osteonecrosis of the Jaw
Osteonecrosis of the Jaw
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Denosumab Administration
Denosumab Administration
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Denosumab Instructions
Denosumab Instructions
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Denosumab: Contraindications
Denosumab: Contraindications
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Study Notes
- Denosumab is the only FDA-approved monoclonal antibody against RANKL for osteoporosis treatment.
- It is used in postmenopausal clients, clients assigned male at birth with high osteoporosis risk, and those at increased risk of fractures or osteoporosis due to long-term glucocorticoid therapy.
Prototype and Classification
- Denosumab is the prototype monoclonal antibody against RANKL.
- It is classified as a bone resorption inhibitor.
Pharmacologic Action
- Denosumab binds to RANKL, reducing osteoclast production and activation by osteocytes.
Adverse Reactions
- Hypocalcemia, osteonecrosis of the jaw, atypical femur fractures, and musculoskeletal pain are associated with denosumab use.
- Common side effects include upper respiratory infections, hypertension, headaches, and diarrhea.
Interventions
- Resolve pre-existing hypocalcemia before starting denosumab therapy.
- Clients taking denosumab for androgen loss-related osteoporosis should take daily calcium and vitamin D supplements.
Safety Alert: Pregnancy
- Denosumab can harm a fetus, so pregnancy testing is required before starting therapy for those who can become pregnant.
Administration
- Administer 60 mg denosumab every 6 months via subcutaneous injection.
- Discard the medication if the solution is cloudy.
- Healthcare professionals should administer denosumab.
Client Instructions
- Take supplemental calcium and vitamin D while on denosumab for osteoporosis.
- Perform regular weight-bearing exercises like walking.
- Practice good oral hygiene and report jaw pain or loose teeth to the provider.
- Inform dentists about denosumab use.
- Report hypocalcemia symptoms like muscle cramps, numbness, or tingling.
Contraindications and Precautions
- Denosumab is contraindicated in clients with active infections.
- Use with caution in clients with chronic infections or a history of serious/opportunistic infections.
- Adjust the dosage for clients with severe kidney disease.
Interactions
- Concurrent use of denosumab with immunosuppressants increases the risk of serious infections.
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Description
Denosumab is a monoclonal antibody against RANKL used for osteoporosis treatment in postmenopausal clients and those at high fracture risk. It inhibits bone resorption by reducing osteoclast production. Adverse effects include hypocalcemia and osteonecrosis of the jaw.
