Osteoporosis

Question 1

Progressive bone disease reduces…. And causes a likelihood of??

Answer 1

reduction of bone mass and density causing increased risk of fractures

Question 2

Risk factors:

Answer 2

• Postmenopausal women
  
  • Men over 50
  • Patients taking long term oral corticosteroids - glucocorticoid steroids
  • Age increase
  • Vitamin D and vitamin C Defieicncy
  • Lack of exteriorise
  • Low BMI
  • Smoking drinking
  • History of fractures
  • Early menopause

Question 3

Lifestyle change:

Answer 3

Increase exercise
Smoking cessation
Maintain ideal BMI
Reduce alcohol intake
Increase intake of vitamin D and C supplements if needed

Question 4

Treatment of osteoporosis requires reviewing after….. ( zoroooooo)

Answer 4

Review medicine after 5 years ( 3 years for zoledronic)

Question 5

First Line:

Answer 5

• Oral bisphosphanates( alendronic acid/risedronate sodium)

Question 6

Alternative therapies:
Post menopausal?
Younger menopausal?
Men?
Glucocorticoid induce

Answer 6

• Post menopausal: ibandronic acid, denosumab, raloxifene,strontium
  
  • • Younger menopausal women can use HRT tibolone
  • Teriparatide used in severe osteoporosis
  • Men: zoledroic acid,densosumab, teriparatide,strontium
  • Glucocortcosteroid -induced: zoledronic acid,densosumab,teriparatide

Question 7

Glucocorticoid induced osteoporosis-
Start prophylaxis in the following (women and men ) and also large doses of CC for more than 3months

Answer 7

Start prophylaxis at onset of glucocorticoid treatment in the following-

Women:
- 70 years or over
- Previous fragility fracture
- Large doses of glucocorticoids (prednisolone less than greater than 7.5 or equal to daily

Men aged equal to and greater over AND either:
- Previous fragility fracture
- Large doses of glucocorticoid

Large dose of corticosteroid for less more than 3 months

Question 8

Bisphosphonates - MHRA warning:

Answer 8

Atypical femoral fractures - Report any hip,thigh or groin pain
Osteonecrosis of the jaw - Report any dental pain,swelling,non-healing sores or discharge
Osteonecrosis of the external auditory Canal - report ear pain or ear infection

Question 9

Bisphosphonates - Side effects:

Answer 9

OESOPHAGEAL Reactions-
Report and stop - oesophageal irritation,dysphasia,heart burn
Medication should be taken with a full glass of water whilst standing and should remain upright for 30 mins after

Question 10

Alendronic acid-

Answer 10

take 30 mins before breakfast/other oral meds

Question 11

Risedronate sodium as well as 30 mins before BF should …

Answer 11

take 30 mins before breakfast or leave 2 hours before and after food/drink if at any other time of the day