Osteoporosis Pharmacology (Msq Drill 150)

1. Bisphosphonates are antiresorptive agents that work to inhibit:

Osteoblasts

Osteoclasts

2.
What class of drug is raloxifene (evista) that is also used in the treatment of osteoporosis?

Antiresorptive

Anabolic

Selective estrogen receptor modifier

3. What about in the liver and bone, what is the mechanism of action of raloxifene (evista?)

Estrogen agonist

Estrogen antagonist

4. A T score between -2.5 and -1 is osteopenia or osteoporosis?

Osteopenia

Osteoporosis

5. Teriparatide (forte) is an _________ agent that is used to treat osteoporosis.

Antiresorptive

Anabolic

Selective estrogen receptor modifier

It is the only available anabolic agent.

Explanation

It is the only available anabolic agent.

6. Therefore teriparatide (forteo) stimulates bone growth. True or false?

True

False

7. If a patient taking a bisphosphonate starts to have epigastric pain, when should they report it?

At the next doctor's appointment

At their earliest convenience

Immidately - STAT

8. Because raloxifene works in the liver, is it necessary to monitor the patient's lipid profile?

Yes

No

9. For post menopausal women will estrogen replacement therapy be indicated as a way to maintain bone in the prevention of osteoporosis?

Yes

No

10. Should bisphosphonates be taken with food?

Yes, they should always be taken with food with a FULL glass of water

No, they should be taken on an empty stomach with a FULL glass of water

11. Teriparatide (forteo) is basically used for patients who are at a very high risk of osteoporosis. True of false?

True

False

12. If a patient has hypercalciuria, should you administer calcium?

Yes

No

13. Is it appropriate to tall a patient that they should not lie down for at least 30 minutes after taking a bisphosphonate and that if they should lie down they should do so after the first food of the day is eaten?

Yes, this is appropriate patient education

No, this is inappropriate patient education

14. To maximise absorption of calcium, it shoulde be taken:

Once a day

Twice a day

15. Why do we give calcium and vitamin D to women either at risk for or who have osteoporosis?

To encourage bone resorption

To maintain bone

16. Should all patients with osteopenia be immediately started on osteoporosis treatment?

No, there is no indication

Yes, if they have a risk factor

17. Is hypercalciuria and hypercalcemia also a contraindicationfor Vitamin D?

Yes

No

18. Raloxifene (evista) is indicated for ______________ of osteoporosis.

Prevention only

Treatment only

Prevention and treatment

19. A patient with a creatnine clearance of less than _______ should not take bisphosphonates.

15

30

40

45

20. What is the daily requirement for elemental calcium?

400-800mg

800-1000mg

1000-1500mg

21. Multivitamins usually have about how much Vitamin D?

400-800IU

800-1000OIU

22. Which of the following types of calcium supplements is the cheapest and has the highest amount of elemental calcium by weight?

Calcium carbonate

Calcium citrate

Calcium phosphate

23. Osteonecrosis of the jaw is a common side effect of bisphosphonates. True or false?

True, it is a common side effect

False, it is a rare side effect

24. Clacitonin reduces the risk of _______ fracture and is thought to also have an ANALGESIC effect.

Hip

Elbow

Distal radius

Vertebral

25. Vitamin D is usually supplied as Vit D2 and Vit D3. Which one is over the counter?

D2

D3

26. Which of the following calcium supplements needs acid to absorb and should therefore not be taken with proton pump inhibitors. It should be taken with food.

Calcium carbonate

Calcium citrate

Calcium phosphate

27. Calcitonin is also used in the treatment of osteoporosis. Is it an antiresorptive or anabolic agent?

Antiresorptive

Anabolic

28. In the breast and centrally what is the mechanism of action of raloxifene (evista?)

Estrogen agonist

Estrogen antagonist

29. Patients less than 50 years old should take ________ of vitamin D per day.

400-800IU

800-1000IU

1000-1500IU

30. Which of the following should not take teriparatide (forteo?) Patients with:

Metabolic bone disease

Hypercalcemia

Bone malignancy

Hyperparathyroidism

Children or pregnant women

Submit

31. Which of the following are antiresorptive drugs used to treat osteoporosis?

Alendronate (fosamax)

Risedronate (actonel)

Ibandronate (boniva)

Zoledronic acid (reclast)

Raloxifene (evista)

Submit

32. Patients with which of the following conditions should not take bisphosphonates?

Hypocalcemia

Renal impairment

Esophageal abnormalities

Inability to remain upright for at least 30 minutes post dose

Submit

33. Which of the following types of calcium supplements causes less constipation but is also the most expensive?

Calcium carbonate

Calcium citrate

Calcium phosphate

34. Which are the correct pairings?

Vit D2 - cholecalciferol

Vit D2 - ergocalciferol

Vit D3 - ergocalciferol

Vit D3 - cholecalciferol

Submit

35. Can women who are breast feeding take teriparatide (forteo)?

Yes

No

36. Which of the following are side effects of calcium suplementation?

Gas

Constipation

Diarrhea

Nephrolithiasis

Submit

37. Which of the following are drugs or classes of drugs that can induce osteporosis?

Cheotherapy

Steroids such as gluccocorticoid

Immunosuppresants used in organ transplantation

Excess thyroid replacement

Long term heparin

Submit

38. Which of the following does not need acid for absorption but has less elemental calcium and is more expensive?

Calcium carbonate

Calcium citrate

Calcium phosphate

39. Which of the following also can cause osteoporosis?

Proton pump inhibitors such as omeprazole

SSRIs

Seizure medications

Steroids

Drugs for hyperthyroidism

drugs for hypothyroidism are associated with osteoporosis if they are given in excess.

Explanation

drugs for hypothyroidism are associated with osteoporosis if they are given in excess.

Submit

40. 1 mcg of Vit D is = to how many international units?

20

40

60

80

100

41. There are some higher potency vitamind D that are used to treat renal osteodystrophy. these include which of the following:

25-hydroxy D3 - calcifediol

25-hydroxy D2 calciferol

1,25 dihydroxyD3 - calitriol

Submit

42. If you take a high dose of vitamin D will it increase or decrease your bone mineral density?

Increase

Decrease

43. Calcium can decreased the absorption of which of the following drugs?

Levothyroxine

Fluoroquinolones

Tetracyclines

Bisphophonates

Propylthiouracil

Submit

44. A patient with osteopenia and one risk factor should be started on treatment. Which of the following could be one of the risk factors?

Secondary causes such as steroid use

History of a fracture

Family history of osteoporosis related fractures

High 10 year probablity of fracture

Submit