drugs

Question 1

cv: 65/F fears of fracture risk due to maternal history of osteoporosis. underwent menopause ag 52, hx of hypertension, hyperlipidemia, coronary artery disease, seizure disorder and GERD.

which drug used long term may increase patient’s risk of osteoporosis and hip fracture?

a. atorvastatin
b. chlorthalidone
c. levetiracetam
d. metoprolol
f. omeprazole

Answer 1

f. omeprazole

calcium needs acidic environment to be absorbed. PPI decrease absorption of dietary calcium in GIT.

other drugs that can cause risk for osteoporosis include:

1. glucocorticoids - decrease bone formation
2. aromatase inhibitors, GnRH agonists - decrease estrogen production
3. anticonvulsants that induce cyp450 (phenobarbital, phenytoin, carbamezapine) - increase Vit. D catabolism = lower bone density

• chlothalidone (thiazide diuretic) decreases risk because it causes calcium absorption in the distal renal tubule