osteoporosis 1 Flashcards
How common is osteoporosisi
50% of women over 50 and 25% of men over 50 will have at least 1 osteoporotic fracture.
risk factors for osteoporosis that you can’t change
women, small stature, increasing age, ethnicity/caucasion or asian, family hx/first degree relatives with fractures
risk factors for osteoporosis that you can change
Low Ca and Vitamin D, Low estrogen, inactive lifestyle, smokeing, alcohol, steroids, anticonvulsants.
two specific drugs that may increase risk of osteoporosis
glucocorticoids and anticonvulsants
what treatmetns are used for osteoporosis
Ca, Vit D, Mg, Strontium, bisphosphonates, SERMS , synthetic calcitonin, PTH analogues, estrogen, monoclonal antibodies
when is adding Ca to diet benefitioal to prevent osteoporotic fractures
only before first fracture, after it won’t help by itself
what may be better absorbable Ca
Calcium citrate
why is Vit D important
allows Ca absorption in GI, made in skin
Calcitriol is what
perscription form Vit D,
caution with calcitriol
may elevate serum Calcium levels and so it must be monitored
when is Mg helpful
when given with Ca and Vitamin D
what mineral may increase osteoblastic activity
strontium
What is approved both for treating and preventing postmenopausal, glucocorticoid incuced osteoporosis
Bisphosphonates, selective estrogen receptor modulator
what is Raloxifene
selective estrogen receptor modulator - treat and prevent
Calcitonin
Treatment only
Teriparatide the PTH analogue
Treatment for postmenpausal and men with high risk of fracture
ET?HRT
prevention for postmenopausal osteoporosis
denosumab - human nonoclonal antibody
Treatment
what drugs are approved for treatment of osteoporosis
Bisphosphonates, selective estrogen receptor modulators, Calcitonin, PTH analogue, and human monoclonal antibodies
what drugs are approved for prevention
Bisphosphonates, selective estrogen receptor modulators, ET/HRT
MOA bisphosphonates
inhibit osteoclasts to increase bone mass
majro problem with bisphosphonates
erosion of esophagus, and they are not very bioabailable, osteonecrosis of jaw, and atypical femur fractures
Bisphosphonates
Bisphosphonates: Alendronate/Fosamax
Bisphosphonates: Alendronate/Fosamax
Prevent and treat via osteoclas inhibition, once daily
SERM - selective estrogen receptor modulators
try to act like estrogen without increasing cancer risk
SERM drugs:
Raloxifene/Evista
SERM: Raloxifene Evista
increase bone mass, reduce fracture risk and breast cancer by binding to estrogen receptor sites.
side effects raloxifene
hot flashes, arthralgias, dvt.
contraindicatiosn of SERM: Raloxifene/evista
Pregnant and lclacting woment or those with hx of DVT
