Selective Estrogen Receptor Modulators and Bisphosphonates
TERMS
□ alendronate (Fosamax)
□ raloxifene (Evista)
QUICK LOOK AT THE CHAPTER AHEAD
Selective estrogen receptor modulators (SERMs) work on estrogen receptors and are indicated for the prevention of postmenopausal osteoporosis. Raloxifene (Evista) is indicated for the treatment and prevention of osteoporosis. Tamoxifen (Novadex) is an antineoplastic, used as an adjunct in the treatment of breast cancer, after surgery or radiation, and in the prevention of breast cancer in high-risk clients.
Bisphosphonates are also known as bone resorption inhibitors and are used to treat or prevent osteoporosis. Alendronate (Fosamax) is the first bisphosphonate in its class.
Table 57-1 Tetracyclines | ||||||||||||||||||
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SELECTIVE ESTROGEN RECEPTOR MODULATORS AND BISPHOSPHONATES CLIENT TEACHINGSelective Estrogen Receptor Modulators (SERMs)
Periodic laboratory testing CBC with a differential and platelets is indicated.
For oral SERMs, antacids may help reduce GI distress.
Teach client to assess for symptoms of thrombophlebitis and to immediately report symptoms to health care provider.
Make client aware that she may experience hot flashes or flushing.
Take exactly as prescribed.
Advise other health care providers (eg, specialist, surgeon, dentist) about medication use before surgery or treatment.
Periodic laboratory testing CBC with a differential and platelets is indicated.
For oral SERMs, antacids may help reduce GI distress.
Teach client to assess for symptoms of thrombophlebitis and to immediately report symptoms to health care provider.Raloxifene (Evista)
Can be taken without regard to meals
Notify health care provider if pregnancy is suspected as raloxifene may have teratogenic effects.
Encourage regular weight bearing exercise such as walking.
Teach client which foods are high in calcium and vitamin D.
Consult with health care provider about calcium and vitamin D supplements.
Encourage client to stop smoking and limit alcohol intake.
Notify health care provider if pregnancy is suspected as raloxifene may have teratogenic effects.Tamoxifen (Novadex)
Take with food if GI distress occurs.
Omit dose if missed.
Do not take an antacid within 1 to 2 hours after taking an entericcoated tablet.
Monitor weight weekly and report weight gain or edema to health care provider.
Report bone pain to health care provider as analgesics may be ordered to control pain.
Bone pain usually is relieved over time and is an indication of the drug’s effectiveness.
Use nonhormonal contraception during therapy and for at least 1 month after surgery as the drug may have teratogenic effects and may also stimulate ovulation.
Bone pain usually is relieved over time and is an indication of the drug’s effectiveness.Toremifene (Fareston)
If you are childbearing age, use barrier contraceptives.
Do not take if pregnant.
Take without regard to food.
Take without regard to food.
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