Osteoporosis Flashcards
Osteoporosis
Chronic, progressive, metabolic bone disease with low bone mass and deterioration of tissue that leads to increased bone fragility. —> Bone breakdown exceeds bone building!
Incidence
Higher in White and Asian women.
Risk Factors
Low Ca+, low vitamin D, age, smoking, alcohol use, sedentary lifestyle, immobility, BMI less than 19, anorexia, glucocorticoid use of 3+ months or use of anticonvulsants (they increase osteoclast activity)
S&S
Usually none until first fracture! Fractures common at hips, spine, & wrist (Colle’s), Dowager’s hump/kyphosis, height loss d/t spinal fractures, lower back/neck/hip pain (on palpation or with activity).
Diagnostics
Bone Density Test (DEXA) - measures amount of calcium and other minerals in your bones, and the density of your bones.
Nutritional Interventions
Adequate Calcium and vitamin D intake, foods high in Ca+ = milk, yogurt, turnip greens, sardines, spinach, cottage cheese.
Interventions
Weight-bearing exercise, smoking cessation, decrease alcohol use, SAFETY! Fall prevention is huge!
Bisphosphonates
Inhibit bone resorption and slow remodeling. Ex.) Alendronate, Risedronate, etc. AE = anorexia, weight loss, gastritis, inflamed esophagus, osteonecrosis rarely.
Take with full glass of water on empty stomach, wait one hour before eating.
Monoclonal Antibody
Denosumab = Decreases osteoclast activity to help increase bone mass and strength. For postmenopausal women and those with high risk of fractures.
Selective Estrogen Receptor Modulator (SERM)
Raloxifene - reduces bone resorption and risk of vertebral fractures! AE = leg cramps, hot flashes, blood clots.
Teriparatide
Recombinant form of PTH - increases action of osteoblasts and makes them live longer = new bone formation! For men and postmenopausal women with high risk of fractures. AE = dizziness and cramps.
Calcitonin
Decreases activity of osteoclasts - risk of hypocalcemia.
