Take first thing tomorrow

Take first thing tomorrow

if >1 day, skip dose for week

Continue on original schedule

if >7 days to next dose, take next morning

go back to original schedule

Don't take >1 per 7 days.

Counseling for Bisphosphonates

(Alendronate & Risedronate)

• 30 minutes before food/drinks
• with 8oz water
• Sit/stand for 30 minutes
• No other drugs for 60 mins.

• Climera
• Orthoest
• Premarin
• Estratab

• Prempro
• FemHRT
• Premphase

Bisphosphonate (PO)

10mg QD

CRCL <35

(Actonel) Bisphosphonate (PO)

5mg QD

(Boniva) Bisphosphonate (PO/IV)

2.5mg QD

60 minutes

(Reclast) Bisphosphonate (IV)

QY

(Evista) Estrogen agonist/antagonist (PO)

Risk: Blood clot

(Fortical) Nasal

5 year post menopause

Binds to RANKL (SC)

Osteoclast apoptosis

Recombinant PTH Builds bone (SC)

Post menopause + highest risk

2 years max, osteosarcoma

BMD

• Who?

• women ≥65 & Men ≥70
• Postmenopausal/Risk/Fracture  ≥50
• Bone degenerative med

T scores

• Normal
• Osteopenic
• Osteoperotic
• Severe:

• Normal: -1 or above
• Osteopenic: -2 to -2.5
• Osteoperotic: < -2.5
• Severe: -2.5 + fracture history

Below average: ≤-2

Within expected: >-2

25(OH) D

• Deficient
• Insufficient
• Normal

• Deficient: ≤20
• Insufficient: 21-29
• Normal: ≥30

Daily amount for adults over 50

Calcium

Daily amount for adults over 50

Vitamin D

• C
• D
• E
• F
• G

• Ca
• D vitamin
• Exercise
• Fall prevention
• Good habbits

1000 = 400

WF BID

1000 = 210

Citrical

(Food not important)