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Calcium Medication
Question | Answer |
---|---|
What is the most common drug class for osteoporosis and considered 1st line therapy for women with osteoporosis? | Bisphosphonates |
What are the two class of drugs considered to be the 1st line therapy for women with osteoporosis? | Bisphosphonates and Monoclonal Antibody |
What are the drugs under Bisphosphonates? | Fosamax, Reclast, Boniva, Aredia, Actonel (FoRe BoArAct) |
What are drugs under Monoclonal Antibody? | Denosumab (Prolia) |
This calcium supplement is taken with food | Os-cal |
What are side effects of calcium Supplements? | Constipation, Nausea and Vomiting |
What drugs under Calcium supplements? | Calcium Carbonate and Calcium Citrate |
All calcium supplements require drinking 6-8oz of water to prevent what? | urinary or renal calculi |
True or False: Do not divide dose of calcium supplements so it can easily absorbed by the GI | False |
This drug is administered by HCP as SQ injection every 6 months | Monoclonal Antibody - Prolia |
The patient takes Prolia, what does the nurse need to assess? | assess BMD before, and periodically during treatment |
Lidocaine should be intact on the skin for how long? | 12 hrs./day |
How may patches of Lidocaine is allowed at one time? | 3 patches |
This class of drug have side effects of GI irritation, GI bleeding, stomach ulcers, tinnitus, vertigo, bronchospasm | NSAIDs |
What drugs under NSAIDs? | Toradol, Ibuprofen, Aleve, ASA |
ASA use can increase risk for? | Bleeding with anticoagulant |
What do you need to assess on a patient who uses NSAIDs aside from dizziness and GI bleeding? | Fluid retention, Peripheral Edema and pain |
What are S/S of Lidocaine? | Stinging, burning, erythema at patch site, contact dermatitis |
What is the action of Calcitonin? | Secreted by thyroid gland and inhibits osteoclastic bone resorption |
What drugs are under Calcitonin? | Calcimar, Fortical, Miacalcin |
This class of drug is available in IM SQ and intranasal spray forms | Calcitonin |
What are side effects of Calcitonin? | hypocalcemia, nasal irritation, nausea and facial flashing with IM and SQ, injection site irritation |
What interventions should you tell to the patient who was given Calcitonin? | alternate nostril to prevent dryness, store in refrigerator, administer injection at night to decrease SE, calcium supplementation needed |
What outcomes does the nurse expect to a pt who takes calcitonin? | Increase BMD without med SE; slowed progression of postmenopausal osteoporosis; decreased bone pain |
What do you need to assess or tell the patient before starting on Bisphosphonates? | Have a dentist exam d/t jaw osteonecrosis prior starting; assess for evidence of esophageal irritation, difficulty swallowing, wt. loss gastritis, heartburn, and renal insufficiency |
What is the action of Bisphosphonates? | Inhibits osteoclastic bone resorption to increase BMD and total bone mass; treat and prevent osteoporosis |
What interventions would you include to a pt who takes Bisphosphonates? | take early in am; 30 minutes before other meds/food/drinks; take with water; remain upright for at least 30 minutes |
Fosamax is taken how often? | daily or weekly tablet |
Boniva is taken how often? | Once per month tablet |
Reclast is taken how often? | once yearly by IV infusion |
Aredia is taken how often? | pre-treat with Tylenol every 3-6 months |
Reclast have what side effects? | no GI side effects since it's an injection; fever, flu-like syndrome, HA occurring within 3 days of infusion |
Side effects of Bonica, Aredia, Actonel, and Fosamax? | wt. loss, anorexia, abdominal pain, esophageal irritation, dyspepsia, dysphagia, MS pain |
What class of drugs have a drug of raloxifene (Evista)? | Estrogen Agonist |
What are side effects of Evista? | hot flushes, thromboembolism, stroke, and leg cramps |
A pt uses Evista, what do you need to assess? | BMD before, and periodically during treatment, monitor SE |
Interventions for Evista? | Teach importance of Vit D and calcium, no smoking or alcohol, weight bearing exercises, will not reduce flashes of menopause, administer PO |
What is the action of Evista? | synthetic estrogen that inhibits bone resorption used in treatment and prevention of postmenopausal osteoporosis |
What drug is under Parathyroid Hormone? | Forteo |
Parathyroid action? | Increases BMD, stimulate osteoblastic activity therefore stimulates new bone growth; treatment in women high in fractures |
What do you need to assess on pt who takes Forteo? | BMD before, periodically during treatment; Increases serum calcium and decrease serum phosphorus; side effects |
Interventions for pts who take Forteo? | should not be used for more than 2 yr; daily SQ injection into thigh or abdominal wall; store pen in refrigerator; Forteo pen can only be used for 28 days |
Side effects of Forteo? | Orthostatic Hypotension, muscle spasm, leg cramps, dizziness |
Calcium supplements should be taken in combo with? | Activated vitamin D |
Assessment to do to pt who uses Calcium supplements? | monitor Vit D and serum calcium to prevent hypercalcemia; history of urinary stones; understanding of dietary sources of calcium |
Action of Prolia/Monoclonal Antibody? | Binds to a protein involved in formation and function of osteoclast; used for postmenopausal women with osteoporosis at high r/f fractures |