Osteoporosis Flashcards
What is osteoporosis?
Chronic metabolism disease in which bone loss causes decreased bone density and possible fractures
When does bone density begin?
Age 30
When does osteoporosis occur?
When osteoclastic activity is greater than osteoblastic activity
Age, fam history, thin/lean frame, calcium/vit D deficiency, prolonged steroid use, estrogen deficiency, smoking, alcohol (more than 3/day) excessive calcium/caffeine, increase in phosphate, protein deficiency and immobility are all what?
Risk Factors
What helps prevent bone loss?
Estrogen
The diagnostic test T-score measures what?
Bone mineral density (positive score is less than 2.5)
Which diagnostic test is gold standard for osteoporosis?
DEXA Dual X-ray Absorptiometry
What is DEXA?
Bone density scan; shows the T score
What is Peripheral quantitative ultrasound (pQUS)?
Low cost ultrasound diagnostic test
What are some manifestations?
Loss of height, progressive curvature of spine, low back pain, fractures
What are some important nutritional interventions?
Adequate protein, Mg, Vit. K, trace minerals and increase in Ca/vit. D intake. Minimal alcohol/caffeine consumption
What are some lifestyle interventions?
Exercise (wt. bearing) like swim/walk, strengthen abd/back muscles, smoking cessation, fall prevention and fall risk assessment
What kind of exercises should be avoided to prevent compression of the vertebrae?
Running, bowling, horseback riding
What supplementation is commonly given?
Calcium w/ or w/o D- Oscal, Citracal
Oscal, Citracal is most readily utilized when?
Empty stomach and when @ rest
What should be encouraged when a pt is taking Oscal, Citracal?
Adequate fluid intake
What is the normal dosing for Oscal, Citracal?
PO divided doses of 1-1.5g
What are some bisphosphonates used in treatment of osteoporosis?
Fosamax, Actonel and Boniva
What is the normal dosing for Fosamax?
5mg PO QD or 35mg PO weekly (prevent) 10mg PO QD or 70mg PO weekly (treat)
What is the normal dosing for Actonel?
PO QD weekly or monthly
What is the normal dosing for Boniva?
PO monthly or IV Q3mon
What are some Selective Estrogen Receptor Modulators (SERM) used in treatment of osteoporosis?
Evista (oral only)
When is Evista contraindicated?
When known DVT, pulmonary embolism or retinal vein thrombosis or history of
What are some side effects to Evista?
Hot flashes, leukopenia
Most common side effects of NSAIDs?
GI bleed and kidney failure
If a pt is to undergo a surgical procedure when should SERM be stopped?
72hrs before
