- Body system
- Bone and joint
- Name stem
- -dronate
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Risedronate, Ibandronate, Zoledronic acid.
How bisphosphonates work
Bind bone mineral and inhibit osteoclast-mediated bone resorption.
Uses
- Osteoporosis
- Paget disease
- Hypercalcemia of malignancy and bone metastases (IV zoledronic acid)
Adverse effects
- Esophagitis and heartburn (oral)
- Flu-like symptoms after IV doses
- Hypocalcemia
- Osteonecrosis of the jaw (rare)
- Atypical femur fractures (rare)
Nursing considerations
- Correct hypocalcemia and vitamin D deficiency first.
- Check kidney function, especially before IV zoledronic acid.
- Encourage dental care before and during therapy.
Patient teaching
- Take oral tablets first thing in the morning with 6 to 8 oz of plain water.
- Stay upright and do not eat, drink or take other medicines for at least 30 minutes (60 minutes for ibandronate).
- Weight-bearing exercise and calcium and vitamin D support bone health.
Bisphosphonates NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which statement shows the patient understands alendronate teaching?
Show answer
Answer D: I take it in the morning with plain water and stay upright for 30 minutes Alendronate must be taken with plain water on an empty stomach, upright, to avoid esophageal injury and ensure absorption.
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Which suffix identifies a bisphosphonate?
Show answer
Answer C: -dronate Bisphosphonates end in -dronate (alendronate, risedronate, ibandronate); zoledronic acid is an exception.
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A patient on alendronate reports new jaw pain and a loose tooth. What should the nurse suspect?
Show answer
Answer A: Osteonecrosis of the jaw Osteonecrosis of the jaw is a rare but serious adverse effect of bisphosphonates.
Frequently asked questions
What are bisphosphonates?
Bisphosphonates (the -dronate drugs) strengthen bone in osteoporosis. Oral forms must be taken with plain water on an empty stomach, upright for 30 minutes.
How do bisphosphonates work?
Bind bone mineral and inhibit osteoclast-mediated bone resorption.
What are examples of bisphosphonates?
Alendronate, Risedronate, Ibandronate and Zoledronic acid.
What are the nursing considerations for bisphosphonates?
Correct hypocalcemia and vitamin D deficiency first. Check kidney function, especially before IV zoledronic acid.