Question

Case Study S Women's Health Agents A 76-year-old Caucasian woman presents for an annual maintenance visit. She is generally feeling well and has no specific complaints. She takes hydrochlorothiazide for hypertension. She went through menopause at age 48 and never took hormone replacement therapy. She is a former smoker having a 30 pack-ycar history and having quit 20 years ago. She occasionally has a glass of wine with dinner and walks three or four times a week for exercise. On examination her height is 1 inch less than it was 3 years ago. Her vital signs are normal. She has a prominent kyphoscoliosis of the spine. Her examination is otherwise is unremarkable. The physician orders a bone density test which shows significant reduction of density in the spine and hips. The physician diagnoses her with osteoporosis and starts her on alendronate sodium (Fosamax), and calcium and Vitamin D supplements. What risk factors does the woman in the case study have to support therapy with alendronate? (10 pts) 2 What precaution should the patient take when setting up the medication schedule for the alendronate and the calcium supplement? (5 pts) Why should this precaution be taken? (5 pts) What is the mechanism of action of alendronate sodium? (20pts) What would the nurse teach the patient about taking alendronate? (30 pts) s Name two common adverse effects of alendronate? (15 pts) What serious condition may result if the patient does not take alendronate as recommended? (15pts)

Answer 1

1)The major risk factors the women who have to get a support therapy during aldendronate are managing her menopausal episodes.Estrogen therapy at this time shall be prescribed to prevent any adverse complications

The factors like taking alcohol and cigarette has formed the main read in for this condition

2)Some of the precautions to be taken while taking aldendronate are

• Not to be taken at bed time
• Should not be taken immediately after getting up from bed
• Should not lie flat for 30 minutes because it could damage the esophagus
• Should not lie flat immediately after taking first food  or breakfast
• Calcium and Vitamin D has to be taken in placebo to prevent inadequacy

3)The medication when taken orally starts acting with a half life of 126months .It inhibits the process of osteoclast by chemically reacting with inorganic pyrophosphate.This in turn does two actions by preventing resorption of bone via osteoclast and simultaneously mineralization will be taken place via osteoblast.As a result of this the new bone formed can be seen with the deposition of aldendronate.To achieve this adequate calcium is necessary for correction.

4)The major side effects are

• Oesophageal cancer or rupture
• Stevenson Johnson syndrome
• Bone pain
• Osteonecrosis of jaw

It is recommended one a week as 35mg or 5mg daily if not taken properly can endanger one's life and result in irreversible damage