Osteoporosis

Question 1

What are lifestyle treatments?

Answer 1

Increasing excercise
Smoking cessation
Maintain ideal BMI
Reduce alcohol
Increase of Vit D and calcium

Question 2

What is first line treatment for osteoporosis?

Answer 2

Oral bisphonates
(Alendronic acid/risedronate)

Question 3

What is alternative treatments for osteoporosis in post menopausal?

Answer 3

Ibradronic acid
Denosumab
Raloxifene
Strontium

Younger menopausal:
HRT or tibolone
Terapartide in severe osteoporosis

Question 4

What are alternative treatment osteoporosis in men?

Answer 4

Zoledronic acid
Denosumab
Teriparatide
Strontium

Question 5

What is alternative treatment in glucocorticoid induced osteporosis?

Answer 5

Zoledronic acid
Denosumab
Teriparatide

Question 6

How often should it be reviewed?

Answer 6

Every 5 years
3 years for Zoledronic acid

Question 7

What groups of people would you start prophylaxis of glucocorticoid-induced osteoporosis?

Answer 7

Women:
>70years Previous fragility fracture
Large doses of glucocorticoid (prednisolone >7.5mg)

Men:
Aged >70 +
Previous fragility fracture
Large doses of glucocorticoid

Large doses of corticosteroids for 3months or more

Question 8

What are bisphosphonates MHRA warnings ?
What counselling would you give to patients?

Answer 8

Atypical femoral fractures
-> report any thigh hip or groin pain

Osteonecrosis of jaw:
-> report dental pain, swelling, non-healing sores or discharge

Osteonecrosis of the external auditory canal
-> ear pain, discharge or ear infection