Topic 10: Osteoporosis Flashcards
Osteoporosis
chronic, progressive bone disease marked by low bone mass and deterioration of bone tissue, leading to increased bone fragility.
Risk factors for osteoporosis
advancing age, female gender, low body weight, white or Asian ethnicity, cigarette smoking, sedentary life style, estrogen deficiency in women, family history, diet low in calcium or vitamin D, excess alcohol (>2 drinks/day), low testosterone in men, long-term use of corticosteroids, thyroid replacement, heparin, long-acting sedatives, or antiseizure drugs
Why is osteoporosis more common in women?
at menopause, women have rapid bone loss when the decline in estrogen is the greatest
clinical manifestations of osteoporosis
· Occurs most often in bones of spine, hip, and wrists
· Early manifestations: back pain and spontaneous fractures
· Gradual loss of height
Humped thoracic spine (kyphosis)
when is an initial bone density test recommended for osteoporosis
Current guidelines recommend an initial bone density test in all women over age 65
diagnostic assessment of osteoporosis
· Serum calcium, phosphorus, alkaline phosphate, vitamin D
· Bone mineral densitometry
· Dual-energy x-ray absorptiometry (DEXA)
Risk for fracture from osteoporosis tool:
Fracture Risk Assessment (FRAX)
managemenr for osteoporosis
· Adequate dietary calcium
· Calcium supplements
· Sun exposure (20 minutes a day) or vitamin D supplements
· Exercise program (weight-bearing exercises; walking, hiking, weight training, stair climbing, tennis, dancing)
· Walk 30 minutes 3 times a week
· Quit smoking and decrease alcohol
foods high in calcium
milk, yogurt, turnip greens, cottage cheese, ice cream, sardines, spinach
minimally invasive procedures for osteoporosis
vertebroplast and kyphoplasty
Vertebroplasty
bone cement is injected into the collapsed vertebra to stabilize the spine and improve the patient’s pain
Kyphoplasty
small balloon is inserted into the collapsed vertebra and inflated to restore vertebral body height before injection of bone cement
teaching for taking calcium
It is difficult for us to absorb calcium in single doses greater than 500 mg, so take calcium supplements as divided doses to increase absorption
teaching for taking biphosphonates
· Take with a full glass of water
· Take 30 minutes before food or other medications
· Remain upright for at least 30 minutes after taking
common SE of bisphosphonates
anorexia, weight loss, and gastritis
