Osteoporosis Flashcards
What is Osteoporosis?
loss of sex steroids causing short life of osteoblasts (build bone) and delay cell death of osteoclasts (breakdown bone)
Risk factors for Osteoporosis
smoking alcohol RA Diseases states Advanced age previous Fx steroids skinny.
What does estrogen do?
promote osteoclast death
and osteoblast activity.
how to scan for OP?
Dexa measure BMD and compares to young normal (tscore and age matched norm (z)
OP for T score?
-2.5 below
+1 to -1 normal.
measure every 1-2 yrs after 65 unless they have risk factors then 50
What are calcium and Vitamin D good at>?
reducing bone loss
improve absorption from GI
decrease renal excretion
bone mineralization.
calcium alone causes deposits in arteries.
What do Bisphosphonates do?i
inhibit osteoclasts bone reabsorption
-enhance osteoclast cell death
dosing for bisphosphonates?
bad bioavailability
take with water and stay upright for 30 min. dont eat, drink coffee nada.
ADR of bisphosphonateS?
ulcer
esophagitis
osteonecrosis of jaw with cancer pt.
rare atypical Fx if taken more than 10 yrs.
if patient complains of dull ache thigh/groin pain, while on bisphosphonates, what could be going on?
spontaneous Fx. refer out.
Effects of Hormone Replacement therapy?
female sex characteristics
endometrial proliferating
increase HDL
dec osteoclast activity and increase osteoblast
When to use HRT?
estrogen deficiency
vasomotor menopause
postmenopause OP
Birth control
What does Birth control do?
increase ovulation by increasing estrogen and progestins.
(decrease LH and FSH secretion and follicular development)
changes endometrium to impair implantation
Concerns for therapy with HRT?
thigh pain
enhance effect of drug by promoting WB
no exercise near injection
avoid increase intraabdominal pressure for oral meds.
ADR of oral contraceptive?
risk of DVT/HTN/OP avoid for ppl with: breast/endometrium cancer CAD thrombophlebitis.
