Osteoporosis? Flashcards
what are fragility fractures?
fracture sustained by a fall from standing height or less
some have no obvious trauma
define OP?
systemic skeletal disease characterised by low bone density and micro architectural deterioration of bone tissue with a consequent increase in bone fragility
what are the most common sites of fragility fractures?
hip
wrist
vertebrae
what are some risks associated with vertebral fractures?
pain
GI issues
reduced mobility
breathing problems
how is OP screened for?
FRAX
-includes BMD
-does not include several important variables
Q-Fracture
what is a DXA scan?
dual energy x-rau absorptiometry
measurement of bone mineral density at spine and hip
gives a T score
what are the ranges for DXA scan?
+1 to -1 = normal
-1 to -2.5 = osteopenia
-2.5 and below = OP
what do bisphosponates do?
inhibit osteoclasts
high affinity for bone mineral
what is denosumab?
-monoclonal antibody against receptor activator of nuclear factor kappa B ligand (RANK ligand) which is required for osteoclast differentiation and function
-potent inhibitory effects on osteoclastic bone resorption
-s/c injection every 6 months
-rebound increase in bone turnover after stopping
what are some common side effects of therapies for OP?
gastritis
MRONJ
AFF
what is teriparatide?
-1-34 N-terminal fragment of parathyroid hormone
-bone anabolic effects
-best at sites with trabecular bone (spine)
what is romosozumab?
-monoclonal antibody that binds to and inhibits sclerotin
-increases bone formation and decreases bone resorption
-monthly for 12 months then need antiresorptive
what is strontium?
-inhibits osteoclast activity
-stimulates biomechanics markers of bone formation
-substitute for calcium in hydroxyapatite
2g at night
only if other treatments can’t be taken and no CV disease
what are some hormone replacement therapies?
HRT
tibolone - (partial oestrogen, progesterone and androgen receptor agonist)
raloxifene (selective oestrogen receptor modulator- SERM)
