Vitamin D and Bisphosphonates

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Questions and Answers

What is a common side effect of calcium supplements?

Joint pain and dizziness

Abdominal distention and constipation (correct)

Headache and nausea

Muscle weakness and fatigue

When should a calcium supplement with vitamin D be taken for optimal absorption?

With a beverage high in vitamin C (correct)

At bedtime

After a heavy meal

On an empty stomach

What is the role of vitamin D in preventing fractures?

Vitamin D alone is more effective than vitamin D plus calcium

Vitamin D alone is effective in primary prevention of fractures

Vitamin D alone is not effective in primary prevention of fractures (correct)

Vitamin D alone reduces the risk of fractures

In what scenario are calcium supplements necessary despite better absorption of calcium from foods?

For individuals with lactose intolerance Signup and view all the answers

What types of drugs should calcium and vitamin D be taken as supplements to?

Drugs prescribed to treat osteoporosis Signup and view all the answers

What type of therapy is no longer recommended for patients who only have evidence of osteopenia without reaching the precise DEXA scores that define osteoporosis?

Bisphosphonate therapy Signup and view all the answers

Which drug is used to treat osteoporosis and should be taken on waking with at least 6 to 8 oz of water, followed by remaining upright for 30 minutes?

Alendronate Signup and view all the answers

Which drug is administered intravenously once a year and is used to prevent and treat osteoporosis?

Zoledronic acid Signup and view all the answers

Which drug is used in the treatment of hypercalcemia, Paget’s disease, and postmenopausal osteoporosis, and is most likely to be effective in hypercalcemia caused by hyperparathyroidism?

Calcitonin Signup and view all the answers

Which drug is an antiresorptive drug used to treat osteoporosis in postmenopausal women at high risk of fracture, and is administered subcutaneously at 6-month intervals?

Denosumab Signup and view all the answers

Which adverse effect is specifically associated with bisphosphonates, including alendronate and zoledronic acid?

Jaw osteonecrosis Signup and view all the answers

Which intervention is recommended to promote absorption and decrease esophageal and gastric irritation after administration of alendronate?

Remaining upright for at least 30 minutes Signup and view all the answers

What is the recommended way to take calcium medications?

With water on an empty stomach and sitting upright for 30 minutes after ingestion Signup and view all the answers

What are the contraindications for calcium medications?

Previously known Barrett esophagus, low serum calcium levels, and pregnancy Signup and view all the answers

What is a reported rare side effect of calcium medications?

Osteonecrosis of the jaw and subtrochanteric fractures Signup and view all the answers

When is IV calcium essential?

For the treatment of acute, severe hypocalcemia Signup and view all the answers

What is a common cause of calcium deficiency in older adults?

Dietary deficiencies and impaired absorption Signup and view all the answers

What can patients with renal impairment use calcium acetate for?

To prevent or treat hyperphosphatemia Signup and view all the answers

What is the recommended route of administration for IV calcium preparations?

Intravenous Signup and view all the answers

What are the therapeutic effects of calcium preparations?

Relief of neuromuscular irritability symptoms and return of serum calcium levels to normal range Signup and view all the answers

In addition to calcium supplements, what may be used in chronic hypocalcemia if calcium supplements alone are insufficient?

Vitamin D Signup and view all the answers

What can excessive use of vitamin D lead to?

Hypervitaminosis D and hypercalcemia Signup and view all the answers

Where is vitamin D metabolized into its active form?

Liver and kidneys Signup and view all the answers

What may patients with renal impairment require for vitamin D therapy?

Calcitriol (Rocaltrol) Signup and view all the answers

What are some adverse effects of alendronate?

Esophagitis, dysphagia, and atypical femur fracture Signup and view all the answers

What is a contraindication for vitamin D?

Hypercalcemia Signup and view all the answers

How should alendronate be taken?

With a full glass of water, at least 30 minutes before breakfast and before any other medications or supplements Signup and view all the answers

What are the nursing implications for vitamin D?

Assessing for therapeutic effects, monitoring for adverse effects such as hypercalcemia, and patient teaching guidelines Signup and view all the answers

What is the purpose of bisphosphonates like alendronate?

To prevent and treat osteoporosis, Paget's disease, and glucocorticoid-induced osteoporosis Signup and view all the answers

What are the potential consequences of accidental ingestion of vitamin D in children?

Acute toxicity, kidney stones, irreversible kidney damage, and muscle and bone weakness Signup and view all the answers

Study Notes

Vitamin D and Bisphosphonates: Patient Teaching and Nursing Implications

Accidental ingestion of vitamin D in children can lead to acute toxicity, causing kidney stones, irreversible kidney damage, and muscle and bone weakness.
Hypercalcemia symptoms include tetany, and contraindications for vitamin D include hypercalcemia and vitamin D toxicity.
Vitamin D may interact with several medications, and it should not be taken with magnesium-containing antacids or mineral oil.
Nursing implications for vitamin D include assessing for therapeutic effects, monitoring for adverse effects such as hypercalcemia, and patient teaching guidelines to avoid vitamin D intoxication and understand dietary sources of the vitamin.
Bisphosphonates like alendronate are used to prevent and treat osteoporosis in postmenopausal women, as well as in men, and for Paget's disease and glucocorticoid-induced osteoporosis in both sexes.
Alendronate suppresses osteoclast activity to reduce bone turnover, leading to gains in bone mass.
Experts do not recommend using alendronate in severe renal impairment (creatinine clearance < 35 mL/min).
Adverse effects of alendronate include esophagitis, dysphagia, esophageal ulcers/erosions, headache, musculoskeletal pain, decreased serum calcium, atypical femur fracture, and osteonecrosis of the jaw.
Contraindications for alendronate include hypersensitivity to the drug, esophageal abnormalities, inability to stand or sit upright for at least 30 minutes, and hypocalcemia.
Alendronate interacts with several medications, and it should be taken with a full glass of water, at least 30 minutes before breakfast and before any other medications or supplements.
Women with low risk for fracture after 3 to 5 years of bisphosphonate therapy are recommended to take a drug holiday of 2 to 3 years.
The nurse plays a crucial role in preventing interactions, administering alendronate properly, and monitoring for adverse effects.

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Description

Test your knowledge on patient teaching and nursing implications related to vitamin D and bisphosphonates. This quiz covers vital information such as adverse effects, contraindications, and medication interactions for these commonly used supplements and medications.