disorders of bone metabolism Flashcards
what is osteoporosis ?
brittle bone disease
bone mineral density of more than 2.5 SD below the normal
what is the difference between osteoporosis and osteopenia ?
osteoporosis is 2.5 below the normal SD
osteopenia is 1 below the normal SD
what are the common sites of fracture associated with osteoporosis ?
hip
vertebral fractures
wrist ( colles fracture )
what medications increase the risk of osteoporosis ?
proton pump inhibitors and corticosteroids
what investigations can be used for the assessment of osteoporosis ?
DEXA scan
FRAX scan
what is the treatment for osteoporosis ?
1- calcium and vitamin D supplementation
2- bisphosphonates
3- denosumab
4- selective estrogen receptor modulator
what are the doses for adequate supplementation of vitamin D and calcium ?
calcium (1000-1500 mg/day )
vitamin D ( 400-800 IU )
how often are bisphosphonates taken ?
once weekly or once monthly if IV
what are the side effects of bisphosphonates ?
ostenecrosis of the jaw
oesophagitis
atypical femoral fracture
how often are RANKL inhibitors taken ?
denosumab are taken subcutaneously every 6 months
what are the side effects of parathormone analogues ?
nausea limb pain headache
hypercalcemia
may increase the chances of osteosarcoma
what type of patients cannot take strontium ranelate ?
patients with DVT
patients with cardiovascular disease
what type of patients cannot take estrogen receptor modulators ?
patients with a history of DVT
patients with a history of CVD
when are selective oestrogen receptor modulators indicated ?
raloxifen
in postmenopausal women with osteoporosis
if we need a medication to reduce the risk of vertebral fracture which medication should be used ?
selective estrogen receptor modulator
