Ger 9 Osteoporosis Flashcards
Prolonged use of what drugs can lead to an ↑ risk for fractures in people both older and younger than 50?
Glucocorticoids
What 3 chronic conditions in younger adults predisposes them to fractures?
Hypogonadism or premature menopause
Malabsorption syndrome
Primary hyperPTH
What 2 fractures in older adults are clinical risk factors for more fractures?
parental hip fractures
vertebral fx
What 2 bad habits in older adults are clinical risk factors for more fractures?
Current Smoking
high alcohol intake
What weight issues predispose older adults as clinical risk factors for more fractures?
Low body weight (< 60 kg)
Major weight loss (> 10% of bw at age 25)
What chronic disease in older adults are clinical risk factors for more fractures?
Rheumatoid arthritis
What method can u measure bone mineral density?
Dual-energy x-ray absorptiometry
sounds futuristic.
How do bisphosphonates, RANK ligand inhibitors, selctive estrogen receptor modulator, hormone therapy, and calcitonin help treat osteoporosis?
They’re anti-resorptive agents
What is the 1 bone forming drug for the Tx of osteoporosis?
Teriparatide
What % of the risk for vertebral fractures is reduced when using pharmacotherapy?
30-70%
Calcitonin and teriparatide may decrease what Sx that’s associated with vertebral fractures?
Pain
True or False: in addition to bisphosphonates, there is evidence that testosterone reduces vertebral fractures.
False
There’s no evidence that testosterone reduces fxs
What are the 4 first line drugs for the prevention of hip, non-vertebral, and vertebral fxs?
Alendornate
Risedronate
Zoledronic acid
Denosumab
What is the first line therapy for preventing vertebral fxs?
Raloxifene
What you should consider in menopausal women for the prevention of fxs?
Hormone therapy
If woment are intolerant of 1st-line therapies, what 2 drugs cna u give for the prevention of vertebral fxs?
Calcitonin or etidronate
What are the 3 drugs for the first line therpy for the prevention of fxs in MEN?
Alendronate, Risedronate, and zoledronic acid
same for women except no denosumab
What are the 2 adverse effects of high-dose Ca supplements?
Increased risk of renal calculi and CV events
What Sx are a side effect to bisphosphonates?
self-limited flu-like Sx
What skin disease is an adverse effect of denosumab?
Increased risk of cellulitis
What “events” are at an increased risk for using raloxifene and hormone therapy?
thromboembolitic events (including PE)
What 2 Ca problems might happen with the use of teriparatide?
hypercalciuria and hypercalcemia
What is the risk if the 10-year fx risk is > 20% or there is a prior fragility fx of hip/spine or there is > 1 fragility fx?
High risk
What should you offer high risk pts?
Pharmacologic therapy
If a high risk pt is already undergoing pharmacological therapy, what must be performed within 1-3 years?
bone mineral density
What might be the cause of continued loss of bone mineral density or a new fx in high risk pts?
poor adherance to therapy, failure to respond to therapy, or previously unrecognized 2o causes of osteoporosis
What is the 10-year fx risk in moderate risk pts?
10-20%
When should you repeat bone mineral densities in moderate risk pts?
after 1-3 yrs
If there is a 10-year fx risk < 10%, what risk is the pt for fractures?
low risk
True or False: despite being a low risk, pharmacological therapy is encouraged to prevent the progression of osteoporosis.
FALSE
typically lifestyle changes is adequate
When should you test for bone mineral density in low risk pts?
5-10yrs
