Family Nurse Practitioner Exam

What pharmacologic agent is not recommended for severe demineralization of cortical bone?

1. Raloxifene (Evista)

2. Calcitonin (Miacalcin)

3. Medroxyprogesterone (Depo-Provera)

4. Calcium with Vitamin D

The correct answer is: Medroxyprogesterone (Depo-Provera)

Medroxyprogesterone (Depo-Provera) is not recommended for severe demineralization of cortical bone primarily because it is a progestin that can have negative effects on bone density, especially when used long-term. This agent may lead to a decrease in estrogen levels if there is a significant reduction in bone mineral density, which further exacerbates the risk of osteoporosis and fractures. On the other hand, the other options have a more beneficial role in managing bone density. Raloxifene is a selective estrogen receptor modulator that can help maintain or improve bone density in postmenopausal women. Calcitonin can also have a protective effect on bone and is used to treat osteoporosis. Lastly, calcium with Vitamin D is critical for bone health, as these nutrients are fundamental for maintaining bone density and preventing osteoporosis. In the context of addressing severe demineralization, Medroxyprogesterone does not provide the desired protective benefits for bone health and may actually contribute to further complications related to bone density.