[NP-Clinical] Re: fosamax

[Dena]

There are LOTS of them on the market-- both in stores and from on-line
companies. Probably the tastiest (and economical) forms of calcium citrate
is Citracal Creamy Bites-- little bite sized "cookies" that come in a greqat
assortment of flavors. Just wish I could remember to actually take mine! <G>
Dena Galler

-----Original Message-----
From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
On Behalf Of Amy Kinzie ANP
Sent: Friday, March 09, 2007 7:09 PM
To: NP Clinical
Subject: Re: [NP-Clinical] Re: fosamax

is there a particular product / supplement that you are recommending to 
patients to meet these needs?

Amy
----- Original Message ----- 
From: "Shelby Havens" <shelbyhavens at bellsouth.net>
To: "NP Clinical" <np-clinical at nurse.net>; <np-clinical at nurse.net>
Sent: Friday, March 09, 2007 12:52 PM
Subject: Re: [NP-Clinical] Re: fosamax


> Calcium citrate is much more easily absorbed than other forms. It should 
> be taken with zinc, vitamin D, and vitamin K as well.
>
> Regards,
>
> Shelby Havens, ARNP
>
>
>>
>> From: Julie Orfirer <jeorf at yahoo.com>
>> Date: 2007/03/09 Fri AM 08:22:22 EST
>> To: np-clinical at nurse.net
>> Subject: [NP-Clinical] Re: fosamax
>>
>> Sue,
>>
>> First you want to be sure that this is someone you want to treat with 
>> drugs.  What is her fracture risk profile?  (Does she have any of the big

>> 4? Personal or first degree family member history of low-trauma fracture,

>> current smoker, weight under 127#)  What are her T-scores?  How old is 
>> she? Hopefully very very soon we'll have the WHO-2 that will give us 
>> those new guidelines (tapping fingers impatiently on her desk for the 
>> past 1-1/2 years...) that may help.  Is she getting enough calcium and 
>> vitamin D?  That's a real toughy for these folks - I think it's a good 
>> place for chewable calciums (a bit easier on them than the giant pills) -

>> there's even a gum now that you chew for 5 minutes (and don't want to 
>> chew any longer than that 'cause it tastes nasty after 5 minutes).  Do 
>> test her 25 (OH) vit D and make sure it's over 32.  (I doubt that it is 
>> unless she's supplementing well - most of our bariatric surg patients 
>> have horrendous vit Ds.)
>>
>> If you do decide that you want to treat her with a bisphosphonate you 
>> might consider the liquid Fosamax.  It's still a big bolus of liquid 
>> because it still needs to be taken with water but we find it more 
>> tolerable for some folks.  If she has problems with it tho the injectable

>> Boniva is probably the best bet.
>>
>> Julie
>>
>>
>> Message: 1
>> Date: Thu, 08 Mar 2007 11:44:52 +0000
>> From: "Sue Wiers"
>> Subject: [NP-Clinical] fosamax
>> To: np-clinical at nurse.net
>> Message-ID:
>> Content-Type: text/plain; format=flowed
>>
>> I have a woman in her mid-fifites who had gastric bypass 4 or 5 years 
>> ago.
>> Subsequently, her surgeon has left the area and no one took over his
>> practice.  The patient had been on ERT (s/p hyst) in the past and was 
>> taken
>> off for reasons that I cannot recall at the moment.  The last two annual
>> bone densities have each demonstrated significant interval loss in 
>> density
>> although still not outright osteoporosis.  Does anyone out there know if 
>> a
>> person following gastric bypass can take Fosomax?  I am not sure if the
>> potential esophageal effects may be more pronounced or not.
>>
>> Sue Wiers FNP
>>
>>
>>
>>
>>
>> "To affect the quality of the day, that is the highest of the arts." - 
>> Henry David Thoreau
>> http://sculpturefest.org/pages/artists2006/markey.html
>>
>> ---------------------------------
>> Be a PS3 game guru.
>> Get your game face on with the latest PS3 news and previews at Yahoo! 
>> Games.
>>
>
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