Falls

Question 1

When do you consider midorine for OH?

Answer 1

If nonpharmacologic therapy (medication reconciliation, increased salt/water intake, abdominal binders, and other physical maneuvers and lifestyle modifications) do not work.

In conjunction with nonpharmacologic therapy, conventional medical treatment has been shown to reduce recurrence by 39% (SOE=A).

Question 2

When is there limited use of midodrine for OH/syncope?

Answer 2

comorbid severe heart disease or uncontrolled hypertension –
Supine hypertension often limits therapeutic treatment, and midodrine titration must be balanced with antihypertensive agents.

Question 3

What is the MOA of Raloxifene (osteoporotic medication)?

Answer 3

a selective estrogen receptor modulator

Decreased estrogen levels lead to increased RANK-L expression in postmenopausal women. The resultant imbalance in bone remodeling leads to excessive bone resorption, with consequent decrease in bone mass and strength.

Question 4

When is Raloxifene contraindicated?

Answer 4

History of deep-vein thrombosis is a contraindication to raloxifene,

Question 5

Lactose intolerant patient should supplement___?

Answer 5

This patient is at high risk of vitamin D deficiency, given her decreased dairy intake due to lactose intolerance and her postmenopausal status; hence, she would benefit from daily vitamin D supplementation. Several trials have reported a beneficial effect of calcium or calcium plus vitamin D on BONE DENSITY in postmenopausal women and older men; the data on fracture rates are more variable