Why is Fosamax contraindicated with patient about to undergo ECT?

[jennyx33]

Hello everyone! I'm currently preparing for my NCLEX and I encounter a question with Kaplan and the correct answer is that Fosamax is contraindicated with patients who are about to undergo ECT. I tried to google the answer and I cannot find any. Can someone tell me why is Fosamax contraindicated with patient about to undergo ECT?

Thanks! :)

[MrChicagoRN, RN]

Probably Bisphosphonate-associated Osteonecrosis (BON) of the jaw.

[itsnowornever, BSN, RN]

Google is your friend. I just looked to find Thea seer myself and a ton of info came up

Posting from my phone, ease forgive my fat thumbs! :)

[powerbeanie60]

The contraindication might be due to a high risk for bone fracture in the client with osteoporosis if they're not sufficiently secured during the ECT.

[ambitiousblonde]

I agree powerbeanie. I would say that the "clue" is Fosamax, which we know is used in treatment of osteoporosis. I would think a person with osteoporosis is already at a high risk factor for fractures/breaks. Imagine sending a shock or jolt through an already weakened bone structure. Just my thoughts :)

[jeanprz86]

hello im thinking if ur undergoing with the treatment right away and before that u take fosamax the indications for the medicine is to stay sitting up at least 30 mins , so doing this procedure will not help when taking fosamax.

This is my opinion what does your rationale states ??

INFO from website : FOSAMAX should only be taken upon arising for the day. To facilitate delivery to the stomach and thus reduce the potential for esophageal irritation, a FOSAMAX tablet should be swallowed with a full glass of water (6-8 oz). To facilitate gastric emptying FOSAMAX oral solution should be followed by at least 2 oz (a quarter of a cup) of water. Patients should not lie down for at least 30 minutes and until after their first food of the day. FOSAMAX should not be taken at bedtime or before arising for the day. Failure to follow these instructions may increase the risk of esophageal adverse experiences (see WARNINGS, PRECAUTIONS, Information for Patients).

[MrChicagoRN, RN]

Double post

[MrChicagoRN, RN]

^ Patient would be NPO pMN. No oral meds would typically be given till after the procedure.

[smcbunnybsn]

I just had this same question on a practice test. The rationale was that the alendronate fosamax is used to treat osteoporosis, and the osteoporosis itself is what put the pt at risk.

[Philippines2015]

This is what Kaplan rationale. I had this type of question too. According to kaplan, person taking fosamax have to take full glass of water and sit upright atleast 30 minutes to prevent esophageal irritation. Plus pt.undergoing ECT Should be NPO to prevent aspiration if pt take fosamax with a full glass of water is at risk for aspiration . My professor mentioned that PT. Undergoing ECT have the same preparation of pt going operation.

[smcbunnybsn]

That's interesting, because they are completely different rationales coming from the same company. For example, in the practice question I just had, the scenario was a pt who takes Fosamax, not that they just took Fosamax, and the provided rationale was clear that we were supposed to see the rx Fosamax and apply their condition of osteoporosis in order to determine the contraindication. I've seen this scenario a few times with Kaplan in different trainers and Qbank questions where the rationale will change. It's rather frustrating because the NCLEX is supposed to be this perfect world, so why can't the exam writers agree on the rules of their perfect world so we can study appropriately?

[KeVo]

I think your explanation on this question provides the best rationale out of all of those I read. Thanks :)