2025
1. Osteoporosis ANS : Progressive loss of bone mass. Increased risk for
fractures. Type 1 occurs primarily in post menopausal women. Type 2 is men and
women. Can be caused by other diseases or medications. Such as oasis, steroids,
heparin, etc.
2. osteomalacia ANS : Softening of the bone. Adults version of rickets. Low
vitamin D. Can also be caused by hyperparathryoidism. Nirmal vitamin d level is
20-80.
3. Paget Disease ANS : Disorder of bone remodeling. Typically occurs in one or
more bones. They tend to have a high alkaline phosphate level.
4. Treatment for Paget's Disease ANS : Zoledronic acid. Given once a year via
IV infu- sion. Also prescribed a high dose biphosphonate and calcitonin.
5. Treatment for osteomalacia ANS : vitamin D and calcium. Give calcitriol is
vitamin d level is less than 10
6. Bisphosphonates ANS : -dronate given for treatment of osteoporosis,
pagets, and osteomalacia
7. Fosamax (alendronate) ANS : Classification ANS : Bone resorption
inhibitor. Bisphos- phonate
Therapeutic Effects ANS : TX and prevention of post-menopausal and cortico-
steroid-in- duced osteoporosis,
Adverse Reactions & side effects ANS : Altered taste, photosensitivity, rash,
muscu- loskeletal pain, fluid overload, esophagitis. Common upset stomach &
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, heartburn, GI effects
Nursing Implications & teaching ANS : Take first thing in the AM, before eating
anything; then pt MUST remain upright for at least 30 mins! Take only with plain
water. Monitor for GI side effects. Use sunscreen to prevent photosensitivity
reactions. Do not give to those with Renal insufficiency
8. Raloxifene (Evista) ANS : Selective Estrogen Receptor Modulator (SERM)
Osteoporo- sis. Give daily. For those that are intolerant to bisphosphonates. Can
cause hot flashes. Don't give to those with a history of DVT, stroke, MI. Can lower
LDL. Has estrogen side effects. Do not give if at a high risk for uterine or breast
cancer.
9. Duavee (conjugated estrogens/bazedoxifene) ANS : First drug to combine
estrogen with an estrogen agonist/antagonist (bazedoxifene)
Drug should be used for the shortest duration possible. Do not give to patient is they
have a uterus or previous DVT, stroke, MI, PE.
10. Calcitonin (Miacalcin) ANS : nasal spray to decrease bone loss from
osteoporosis; instruct pt. to alternate nostrils each day when administering the
nasal spray to decrease rhinitis. Can cause nose bleeds. Does not affect
osteoporosis of the hip.
11. Teriparatide (Forteo) ANS : Given for osteoporosis. Only drug that will build
bone by stimulating osteoblast (building of bone). Given subQ for up to two years.
No longer than two years. After two years give a bisphonphosate.
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