Calcium Metabolism 2 Flashcards
What is the first symptom of osteoporosis?
Fracture
What are the most common fractures associated with a first presentation?
Neck of femur fracture
Colle’s fracture
What can be used to diagnose osteoporosis?
DEXA scan
Dual Energy X-Ray Absorptiometry (DEXA) scan
What are the two values obtained from a DEXA scan?
T-score
Z-score
What is the T-score and what is it good for?
Standard deviation from mean of young healthy population
Useful for identifying the risk of a patient to develop a fracture
What is the Z-score and what is it good for?
Standard deviation from mean of aged-matched control
Used to identify accelerated bone loss, especially in younger patients
What are the values at which osteoporosis and osteopaenia can be diagnosed in a DEXA scan?
Osteoporosis - T-score
Osteopenia - T-score between -1 and -2.5
What is the first line treatment for osteoporosis?
Lifestyle changes:
- Weight bearing exercise
- Stop smoking
- Reduce EtOH
What are the drugs which can be used to treat osteoporosis?
- VitD/Ca
- Bisphosphonates e.g. alendronate
- Teriparatide (PTH derivative)
- Strontium
- Oestrogens (HRT)
- SERMs e.g. raloxifene
What are the pharmacokinetics and pharmacodynamics of bisphosphonates?
They decrease bone resportion
Bisphosphonates do not exist in nature and therefore N-O bond cannot be broken so created bone is REALLY STRONG
What are some things to remember when administering bisphosphonates orally?
Taken once a week with plenty of water
No food ESPECIALLY MILK for an hour
What are the signs of hypercalcaemia?
Polyuria and polydipsia
Constipation
Neuro - confusion/seizures/coma
