Osteoporosis Flashcards
In which patients is osteoporosis most common?
In postmenopausal women and those taking long-term corticosteroid therapy.
What are some risk factors for the development of osteoporosis?
Low body weight, smoking, excess alcohol intake, lack of physical activity, family history, early menopause.
What should those at risk of osteoporosis do to minimise their risks?
Maintain adequate calcium and vitamin D intake. When using corticosteroids, use the lowest effective dose for the shortest duration.
Describe the physiological action of calcitonin.
Decreases blood calcium levels and is involved with parathyroid hormone in the regulation of bone turnover and the maintenance of calcium balance.
What is teriparatide and how is it used?
It is a recombinant form of PTH. Intermittent use activated osteoblasts, leading to an overall increase in bone.
What is the physiological action of cinacalcet?
Sensitises Ca2+ receptors of the parathyroid gland, reducing PTH levels.
What is denosumab and what is its physiological actions?
It is a human monoclonal antibody. It inhibits osteoclast formation, function, and survival, thereby decreasing bone reabsorption.
What do osteoblasts do?
Build up bones - Blasts Build.
What do osteoclasts do?
Break down bones - Clasts Consume.
Give some examples of bisphosphonates.
Alendronate (alendronic acid), risedronate, ibendronic acid.
What is the mechanism of action of the bisphosphonates?
They are absorbed onto growing bone crystals and slow down the rate of bone turnover.
What is one of the main risks associated with the use of bisphosphonates?
Osteonecrosis of the jaw (phossy jaw).
There is a greater risk of osteonecrosis of the jaw when bisphosphonates are administered by which route?
IV.
What monitoring and management should patients on bisphosphonates receive to minimise the risk/impact of osteonecrosis of the jaw?
Dental checks before treatment, routine dental check-ups, maintain good oral hygiene, report any oral symptoms such as pain, swelling, dental mobility, non-healing sores, discharge. Report to doctor or dentist.
There is a rare risk of atypical femoral fractures in which patients on bisphosphonates?
Patients on long term treatment.