Osteoporosis Flashcards
Non-Pharm Tx
-Sunlight
-Smoking cessation
-Alcohol moderation
-Balanced diet
-Weight/aerobic, resistance training
Fall Prevention Strategies
-Wear sturdy, low heeled shoes
-Hip protectors
-Minimize clutter, remove rugs, loose wires
-Install shower seats/handles
-Avoid step-stools
-Avoid meds that impair coordination
-Night lights
Ca Recommendations by Age
51-70
-Male: 1000 mg
-Female: 1200
71+
-Male: 1200
-Female: 1200
VD Recommendation by Age
51-70
-Male: 600 IU (15 mcg)
-Female: 600 IU (15 mcg)
> 70
-Male: 800 IU (20 mcg)
-Female: 800 IU (20 mcg)
Ca Supplements
-Carbonate preferred (take with meals/juice)
-Citrate for older adults (less constipation, better abs)
-Don’t exceed 1200-1500 d/t kidney stones
-Over 500-600 mg = in divided doses
VD Supplements
-Sunlight 5-15 min/day
-Ergo = D2
-Cholecalc = D3
-D3 preferred
Consider Tx If…
-Post-men women and men 50+ who have low-trauma hip or vertebral fracture
-T score <= -2.5 at neck, spine, hip
-T score -1 to -2.5 and FRAX 20+ or hip 3+
Patients with OP
- Bisphosphonates (dronate, za)
- Denosumab (if CI/AE)
Post-meno patients with OP at high risk of fracture
- Romosozumab
- Teriparatide
- Bisphophonate
Alendronate (fosamax)
TX: 70 mg weekly or 10 mg daily
-oral solution of 70 mg weekly
PREV: 35 mg weekly / 5 mg daily
CI: CrCl < 35
Risedronate (actonel)
TX: 150 mg monthly or 35 mg weekly
CI: CrCl < 30
Ibandronate
TX: 150 mg PO monthly or 3 mg IV Q3mo
PREV: 150 mg PO monthly
CI: CrCl < 30
Zolderonic Acid, Zoledronate
TX: 5 mg IV yearly
PREV: 5 mg IV Q2yr
CI: CrCl < 35
Bisphos: AE
All (POGA)
-GI: AP, dyspepsia, esophagitis, ulcers
-MSK, bone pain
-Osteo of Jaw
-Hip fractures (atypical)
Ibandronate: myalgias, cramps
ZA: HypoCa (CI), flu-like, AF, arthralgia, HA
FOP MIC CHAFA
Bisphos: PE
-Take 30+ (60+ for Iband) before food/drink
-Ca: space > 30-60 min apart
-Avoid NSAIDs, aspirin
-Dental exam 2x/yr
-Miss weekly dose: take next day, unless more than 1 day then skip
-Miss monthly dose: take up to 7 days before next scheduled monthly dose
