TE is a 69-year-old Caucasian woman with past medical history significant for
osteoporosis. She currently takes alendronate 10 mg PO daily. She struggles to
remember taking her tablet every day, and is hopeful to find an antiresorptive agent
that can be administered monthly to help improve her compliance. Which of the
following is the best recommendation for TE? Select all that apply.
A
Risedronate
B
Raloxifene
C
Zoledronic acid
D
Alendronate
E
Ibandronate
Give this one a try later!
, AE
Risedronate is taken orally either daily, weekly, or monthly. Ibandronate is
also available as an oral monthly formulation.
Answer b is incorrect.Raloxifene is taken orally daily for treatment.
Answer c is incorrect.Zoledronic acid is given intravenously annually for
treatment.
Answer d is incorrect.Alendronate is taken orally daily or weekly for
treatment.
A patient takes calcium citrate 950 mg at breakfast and dinner due to inadequate
intake from dietary sources. Calculate the amount of elemental calcium in each dose.
Round to the nearest whole number.
Answer is 200 mg of elemental calcium (950 mg × 1 dose = 950 mg × 0.21 [21%
elemental calcium] = 199.5 mg/dose, rounded to 200 mg/dose).
26 Identify the agents that have been associated with osteonecrosis of the jaw. Select
all that apply.
A
Teriparatide
B
Raloxifene
C
Alendronate
D
Zoledronic acid
E
Denosumab
Give this one a try later!
, CDE
These medications have been associated with a rare, but serious adverse
event known as osteonecrosis of the jaw. Patients should be instructed on
this adverse events and the importance of proper dental hygiene.
JR is a 68-year-old white man who presents to the emergency department with a hip
fracture after falling out of bed. He is 5 ft 8 in and weighs 133 lb. His medical history
includes rheumatoid arthritis, currently treated with prednisone 10 mg PO daily (× 2
years), methotrexate 15 mg PO weekly (× 2 years), and folic acid 1 mg PO daily (× 2
years). Which statement represents the best course of action for the patient?
A
JR should have a bone mineral density (BMD) checked immediately to determine if he
has osteoporosis.
B
JR is a candidate for zoledronic acid 5 mg IV with repeat dosing every other year.
C
JR is a candidate for raloxifene 60 mg PO daily.
D
JR is a candidate for teriparatide 20 μg subcutaneous (SubQ) daily.
Give this one a try later!
D
JR appears to have glucocorticoid-induced osteoporosis with a high risk of
fracture (following his low-trauma fracture) and teriparatide is approved for
this indication.
Answer a is incorrect. A clinical diagnosis of osteoporosis can be made
based on the occurrence of a low trauma fracture. It may be useful to have
a baseline BMD to track the effects of therapy moving forward, but it is
unnecessary for diagnostic purposes as JR has suffered a low-trauma hip
fracture in the presence of multiple osteoporosis risk factors (low body
mass index [BMI], rheumatoid arthritis, and chronic prednisone use).
Answer b is incorrect. JR may be a candidate for a bisphosphonate,
osteoporosis. She currently takes alendronate 10 mg PO daily. She struggles to
remember taking her tablet every day, and is hopeful to find an antiresorptive agent
that can be administered monthly to help improve her compliance. Which of the
following is the best recommendation for TE? Select all that apply.
A
Risedronate
B
Raloxifene
C
Zoledronic acid
D
Alendronate
E
Ibandronate
Give this one a try later!
, AE
Risedronate is taken orally either daily, weekly, or monthly. Ibandronate is
also available as an oral monthly formulation.
Answer b is incorrect.Raloxifene is taken orally daily for treatment.
Answer c is incorrect.Zoledronic acid is given intravenously annually for
treatment.
Answer d is incorrect.Alendronate is taken orally daily or weekly for
treatment.
A patient takes calcium citrate 950 mg at breakfast and dinner due to inadequate
intake from dietary sources. Calculate the amount of elemental calcium in each dose.
Round to the nearest whole number.
Answer is 200 mg of elemental calcium (950 mg × 1 dose = 950 mg × 0.21 [21%
elemental calcium] = 199.5 mg/dose, rounded to 200 mg/dose).
26 Identify the agents that have been associated with osteonecrosis of the jaw. Select
all that apply.
A
Teriparatide
B
Raloxifene
C
Alendronate
D
Zoledronic acid
E
Denosumab
Give this one a try later!
, CDE
These medications have been associated with a rare, but serious adverse
event known as osteonecrosis of the jaw. Patients should be instructed on
this adverse events and the importance of proper dental hygiene.
JR is a 68-year-old white man who presents to the emergency department with a hip
fracture after falling out of bed. He is 5 ft 8 in and weighs 133 lb. His medical history
includes rheumatoid arthritis, currently treated with prednisone 10 mg PO daily (× 2
years), methotrexate 15 mg PO weekly (× 2 years), and folic acid 1 mg PO daily (× 2
years). Which statement represents the best course of action for the patient?
A
JR should have a bone mineral density (BMD) checked immediately to determine if he
has osteoporosis.
B
JR is a candidate for zoledronic acid 5 mg IV with repeat dosing every other year.
C
JR is a candidate for raloxifene 60 mg PO daily.
D
JR is a candidate for teriparatide 20 μg subcutaneous (SubQ) daily.
Give this one a try later!
D
JR appears to have glucocorticoid-induced osteoporosis with a high risk of
fracture (following his low-trauma fracture) and teriparatide is approved for
this indication.
Answer a is incorrect. A clinical diagnosis of osteoporosis can be made
based on the occurrence of a low trauma fracture. It may be useful to have
a baseline BMD to track the effects of therapy moving forward, but it is
unnecessary for diagnostic purposes as JR has suffered a low-trauma hip
fracture in the presence of multiple osteoporosis risk factors (low body
mass index [BMI], rheumatoid arthritis, and chronic prednisone use).
Answer b is incorrect. JR may be a candidate for a bisphosphonate,
