Management of Osteoporosis

Question 1

How can treatment for osteoporosis be divided up?

Answer 1

Conservative - increase Vit D/Calcium intake, exercise, walking aids
Medical - antiresorptives, anabolics
Surgical

Question 2

How do bisphosphonates work?

Answer 2

ANTIRESORPTIVE - Inhibit resorption of bone by osteoclasts by mimicking the structure of pyrophosphate, a normal product of metabolism

Question 3

Give some examples of bisphosphonates

Answer 3

Alendronate, risedronate, ibandronate

Question 4

How does calcitonin work?

Answer 4

ANTIRESORPTIVE - slows the rate at which osteoclasts resorb bone by opposing PTH, given by IV injection.

Question 5

How does HRT work?

Answer 5

ANTIRESORPTIVE - Supplements or replaces sex steroids that naturally antagonise IL-6 and TNFa

Question 6

How does teriparatide work?

Answer 6

ANABOLIC - synthetic form of PTH, when given in short bursts it activates osteoblasts to increase bone density, given by SC injection

Question 7

What is the risk of teriparatide?

Answer 7

It can cause osteosarcoma with prolonged use

Question 8

How does Denosumab work?

Answer 8

ANTIRESORPTIVE - it is a type of human monoclonal antibody that prevents the development of osteoclasts, which are the cells that break down bone.