Indications of bisphonates?
Pagets bone disease
Prevention and treatment of osteoporosis (menopausal or corticosteroid induced)
Precautions of Bisphosphonates?
Upper GI conditions - dyspspsia or concominant use of NSAIDs
AF - can worsen AF
contraindications of Bisphosphonates?
Inability to sit upright or stand for 30 minutes after taking it
Side effects of Bisphosphonates?
nausea, vomiting, diarrhoea, hypocalcaemia
oesophageal erosions and ulcers, gastritis, rash
osteonecrosis of the jaw
Dose of alendronate?
post menopausal osteoporosis?
Prevention of osteoporosis?
corticosteroid induced osteoporosis?
10mg daily or 70mg a week
5mg daily, 10mg if woman not receiving oestrogen
Counselling of alendronate?
Take in the morning with a full glass of water at least 30 minutes before food or drink
do not take antacids or calcium supplements
if you have pain on swallowing or worsening heartburn, see your doctor
tell doc if you get joint or muscle pain
tell dentists that you are taking alendronate
Dose of risendronate?
5mg daily or 35mg a week
Indications of calcitriol?
treatment and prevention of osteoporosis
Precautions of calcitriol?
Treatment with digoxin - increases rick of arrhythmias
Treatment with thiazide diuretics, increased risk of hypercalcaemia
renal impairment - use active form
Adverse effects of calcitriol?
Nausea, vominiting, constipation, anorexia, headache
Dose of calcitriol?
0.25 micrograms twice daily for treatment of osteoporosis or prevention of corticosteriod induced
Counselling of calcitiol?
Do not take other calcium supplementation unless your doctor tells you to
Keep dietary intake of calcium consistent
May need blood tests every few months
MOA of stronium?
Increases bone formation and reduces bone resorption
Indications for Strontium?
Treatment of postmenopausal osteoporosis
Precautions of stronium?
- History of or increased risk of VTE -- increases risk
- Renal impariment
Adverse effects of stronium?
- nausea, diarrhoea, headache, dermatitis
- CNS effects (including disturbed consciousness, memory loss, seizures, confusion
- DRESS -- life threatening allergic reaction occus within 3-6 weeks (rash, fever, swollen glands)
Dose of stronium?
2 g once daily at bedtime.
counselling for stronium?
- This medication is best taken at bedtime, at least 2 hours after eating, because food and drink (especially calcium-containing products such as milk) can reduce its absorption.
- Mix the granules in water and drink immediately.
- Seek medical advice promptly if you develop a rash while taking this medicine.