Osteoporosis Drug Chart PDF

Drug Rationale S/E Nrsng Interventions/Client Education Calcium Max a day 2500 mg/day Best if split during the day 1000 mg 50-70 years old \*post menopausal 1200 mg 71 years older Constipation, cramps, N/V, metallic taste \*Kidney stones, IV admin Adverse Effect: hypercalcemia: drowsiness...

Drug Rationale S/E Nrsng Interventions/Client Education Calcium Max a day 2500 mg/day Best if split during the day 1000 mg 50-70 years old \*post menopausal 1200 mg 71 years older Constipation, cramps, N/V, metallic taste \*Kidney stones, IV admin Adverse Effect: hypercalcemia: drowsiness, lethargy, H/A, anorexia, increased urination and thirst, dysrhythmias, cardiac arrest Take with a lot of water 6-8 glasses, Assess for kidney stones prior to starting, Monitor Ca+ levels, observe for signs of hypercalcemia, calcium deposits under the ski, cardiac dysrhythmias, chances in skeletal muscle tone, and urinary stones, Vitamin D 800-1000 u over age of 50, up to 4000 u (max/day) Helps absorb calcium Also in Babies wo are exclusively breastfeed to help prevent osteomalacia (Rickets) Overdose produces signs of hypercalcemia: bone pain, lethargy, anorexia, N/V, increased urination, hallucinations, and dysrhythmias Check hypercalcemia, hyperphosphatemia. Bisphosphonates: natural substance that inhibits the breakdown of bone: used for the prevention and treatment Alendronate, Ibandronate, Risedronate, Pamidronate (IV), Zoledronic acid (IV) Given for osteoporosis, inhibits osteoclastic activity Take: 2 years then have DXA scan, if the bone loss continues, take up to 5 years. N/V, upset stomach, diarrhea, osteonecrosis; bone pain, back pain, Bone fractures: gastric ulcer, esophageal perforation, anemia, osteonecrosis of the jaw, a fib Contraindicated: poor renal function, hypocalcemia, GERD Take on an empty stomach first thing in the morning with a full glass of water help prevent esophagitis, esophageal ulcers, and gastric ulcers. Have the pt. sit up for 30 minutes after taking the drug to prevent esophageal inflammation. \*\*Do not give to pts. sensitive to aspirin. In 1^st^ year, increased osteoclastic, after 2-3 years, plateaus. Have to take Ca+ levels before start, monitor Check Kidney functions, \*\*start doing dental exam drug can cause maxillary osteonecrosis **\ ** +-----------------+-----------------+-----------------+-----------------+ | Estrogen | Osteoporosis, | Blood clots, | Check Liver | | Agonists/Antago | post-menopausal | DVT, hot | Function | | nists | hormone | flashes, | AST/ALT. Teach | | | replacement | trouble | S/S of DVT/VTE | | (SERMS): | treatment; | sleeping, may | especially in | | Raloxifene | mimics estrogen | start spotting | the first 4 | | | in some parts | | months. | | | of the body | Contraindicated | | | | while blocking | : | | | | its effects | Women with a Hx | | | | elsewhere | of VTE, not | | | | | menopausal | | +=================+=================+=================+=================+ | Monoclonal | Block protein | Low Ca+, back | Report new | | Antibodies/RANK | with decreased | pain, increased | muscle skeletal | | L | bone loss, | Cholesterol, | pain in back | | | increased bone | increased risk | | | Denosumab | mass | UTI | S/S of | | | | | infection | | | \*\*use if | Can cause | | | | nothing works | Maxillary | Monitor Ca+, | | | | Necrosis | Mg, Phosphorus | | | | | levels, can | | | | | cause | | | | | hypocalcemia, | | | | | | | | | | \*Get dental | | | | | exam prior to | | | | | starting | +-----------------+-----------------+-----------------+-----------------+ | Calcitonin: | Parathyroid | Can cause | Check for fish | | | hormone, | epistaxis | Allergies: | | Sub intranasal | decreases Ca+ | (nosebleeds), | Salmon | | spray, Sub Q | levels, | and rhinitis | | | | synthetic | | Post-menopausal | | | pill/nose, | | post 5 years, | | | Increased bone | | Check Ca+ | | | density | | levels | | | | | (hypocalcemia) | +-----------------+-----------------+-----------------+-----------------+ | PTH-related | Injectable, | | Used for pt. | | protein drugs | post menopausal | | who have | | | women and men | | fractures and | | \*NOT on Test | | | other risk | | | Build up bone | | factors, after | | | may bot be used | | drug is stopped | | | long term | | usually will be | | | | | put on | | | | | Bisphosphates | +-----------------+-----------------+-----------------+-----------------+