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16 Cards in this Set
- Front
- Back
Osteoporosis
Definition |
low bone mineral density
deterioration of bone tissue increasing fragility of bone risk of fracture osteoblasts - build bone osteoclasts - clear bone |
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Osteoporosis
diagnosis Tscores |
WHO T scores
osteopenia -1 to -2.5 osteoporosis < 2.5 AACE (am ass of clinical endocrinolgst) - initiate tx when *t score < -2 and no RFs *t score < -1.5 w/ RFs |
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Osteoporosis
Risk Factors |
advanced age
cigarette smoking estrogen deficiency fam hx longterm CS use low testosterone in med small frame plus a ton more |
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Osteoporosis
Treatment principles |
adequate Ca and vit D intake
- Ca 1 to 1.5g/day * can absorb 500mg at a time * Carbonate has most elemental Ca * Carbonate absorbed better w/food * Citrate w/ or w/o food - Vit D 800IU/day |
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Osteoporosis
Drug Tx |
Ca + Vit D
Bisphosphonates - alendronate (Fosamax) - risedronate (Actonel) ERT - many, many preps - estrogen alone or combo w/progestin Selective Estrogen R Modulator - raloxifene (Evista) Others - calcitonin (Miacalcin) IN, SC, IM (qd) - teriparatide (Forteo) injection (qd) |
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Osteoporosis
bisphosphonates moa, pt counseling, interactions |
MOA
- incorporates into bone to stabilize Pt counseling - take w/full glass of water 30 min b/f first meal - stay uproght for 30 min Interactions - separate from Ca sups and antacids by 1 hour - ranitidine inc absorb 2 fold |
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Osteoporosis
ERT - CIs |
VTE
breast or endometrial cancer pregnancy genital bleeding |
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Osteoporosis
SERM (raloxifine) moa, pt counseling |
Evista
MOA - dec resorption of bone and turnover pt counseling - take w or w/o food - will not treat postmenopausal SX |
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Osteoporosis
Calcitonin MOA, pt counseling |
MOA - inhibits bone resorption
PT couneling - injection or nasal spray - take qd - store in fridge |
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Osteoporosis
teriparatide (Para thyroid hormone) PTH moa |
inc rate of bone formation by inc birth rate of osteoblasts
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osteoporosis
should do wt bearing exercises? |
yes
will reduce falls and fractures |
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Does calcium prevent fractures?
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No
WHI -builds bone -doesn't reduce fractures |
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When should BMD testing be recommended?
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-all post menopausal women > 65
- < 65 if have 1 or more RFs |
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Should Ca supp be recommended if pt taking Rx Tx for osteoporosis?
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Yes - if diet not adequate
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What are first line treatments (RX)?
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bisphosphonates
raloxifene calcitonin PTH |
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What is the indication for ERT wrt to osteoporosis?
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Prevention NOT treatment
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