Bone metabolism Flashcards
Osteoporosis occurs most commonly in who?
Post menopausal women.
Those taking lon-term oral corticosteroids.
Other risk factors include: low BW Smoking Alcoholism Sedentary lifestyle FH Early menopause
How is osteoporosis treated?
Calcium and Vit D
What needs to be excluded before treatment for osteoporosis should begin?
Reversible causes of osteoporosis such as:
Hyperthyroidism
Hyperparathryoidism
Osteomalacia or hypogonadism.
What can be used for the prevention of postmenopausal osteoporosis?
Bisphosphonates such as alendronic acid and risedronate.
When would HRT be used for preventing osteoporosis?
if other treatments are contraindicated.
When is HRT of most benefit for the prophylaxis of postmenopausal osteoporosis?
if started early in menopause and continued for up to 5 years, but bone loss resumes on stopping HRT.
If bisphosphonates are unsuitable for treatment of osteoporosis what can be used instead?
Calcitriol or strontium ranelate.
Calcitonin is no longer recommended for the treatment of postmenopausal osteoporosis as risk of malignancy outweighs benefit.
What is teriparatide?
recombinant form of parathyroid hormone consisting of the first (N-terminus) 34 amino acids, which is the bioactive portion of the hormone.
Newly introduced for treatment of postmenopausal osteoporosis.
What is raloxifene hydrochloride licensed for?
Prophylaxis and treatment of vertebral fractures in postmenopausal women.
The greatest rate of bone loss occurs during what period of oral corticosteroid use?
6-12 months.
When should parents prescribed an oral corticosteroid be assessed and when needed given a prophylactic osteoporosis treatment?
When likely to be on them for 3 months or longer
Calcitonin (Salmon) is used for what?
To lower the plasma-calcium concentration in patients with hypercalcaemia associated with malignancy.
Also for the treatment of Pagets disease (Paget’s disease of bone disrupts the normal cycle of bone renewal, causing bones to become weakened and possibly deformed) when other treatments have failed.
What is Cinacalcet licensed to treat?
Hypercalcaemia in parathyroid carcinoma.
When should a discussion with patients regarding the cessation of their bisphosphonate treatment for osteoporosis?
After 3 years’ treatment as their is no evidence for benefit after this time.
Strontium ranelate use has been associated with what?
Increased risk of serious cardiovascular disease, including myocardial infarction, and the risk should be assess before treatment and regularly during treatment.
