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Flashcards in Ger 9 Osteoporosis Deck (31)
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1

Prolonged use of what drugs can lead to an ↑ risk for fractures in people both older and younger than 50?

Glucocorticoids

2

What 3 chronic conditions in younger adults predisposes them to fractures?

Hypogonadism or premature menopause
Malabsorption syndrome
Primary hyperPTH

3

What 2 fractures in older adults are clinical risk factors for more fractures?

parental hip fractures
vertebral fx

4

What 2 bad habits in older adults are clinical risk factors for more fractures?

Current Smoking
high alcohol intake

5

What weight issues predispose older adults as clinical risk factors for more fractures?

Low body weight (< 60 kg)
Major weight loss (> 10% of bw at age 25)

6

What chronic disease in older adults are clinical risk factors for more fractures?

Rheumatoid arthritis

7

What method can u measure bone mineral density?

Dual-energy x-ray absorptiometry

sounds futuristic.

8

How do bisphosphonates, RANK ligand inhibitors, selctive estrogen receptor modulator, hormone therapy, and calcitonin help treat osteoporosis?

They're anti-resorptive agents

9

What is the 1 bone forming drug for the Tx of osteoporosis?

Teriparatide

10

What % of the risk for vertebral fractures is reduced when using pharmacotherapy?

30-70%

11

Calcitonin and teriparatide may decrease what Sx that's associated with vertebral fractures?

Pain

12

True or False: in addition to bisphosphonates, there is evidence that testosterone reduces vertebral fractures.

False

There's no evidence that testosterone reduces fxs

13

What are the 4 first line drugs for the prevention of hip, non-vertebral, and vertebral fxs?

Alendornate
Risedronate
Zoledronic acid
Denosumab

14

What is the first line therapy for preventing vertebral fxs?

Raloxifene

15

What you should consider in menopausal women for the prevention of fxs?

Hormone therapy

16

If woment are intolerant of 1st-line therapies, what 2 drugs cna u give for the prevention of vertebral fxs?

Calcitonin or etidronate

17

What are the 3 drugs for the first line therpy for the prevention of fxs in MEN?

Alendronate, Risedronate, and zoledronic acid

(same for women except no denosumab)

18

What are the 2 adverse effects of high-dose Ca supplements?

Increased risk of renal calculi and CV events

19

What Sx are a side effect to bisphosphonates?

self-limited flu-like Sx

20

What skin disease is an adverse effect of denosumab?

Increased risk of cellulitis

21

What "events" are at an increased risk for using raloxifene and hormone therapy?

thromboembolitic events (including PE)

22

What 2 Ca problems might happen with the use of teriparatide?

hypercalciuria and hypercalcemia

23

What is the risk if the 10-year fx risk is > 20% or there is a prior fragility fx of hip/spine or there is > 1 fragility fx?

High risk

24

What should you offer high risk pts?

Pharmacologic therapy

25

If a high risk pt is already undergoing pharmacological therapy, what must be performed within 1-3 years?

bone mineral density

26

What might be the cause of continued loss of bone mineral density or a new fx in high risk pts?

poor adherance to therapy, failure to respond to therapy, or previously unrecognized 2o causes of osteoporosis

27

What is the 10-year fx risk in moderate risk pts?

10-20%

28

When should you repeat bone mineral densities in moderate risk pts?

after 1-3 yrs

29

If there is a 10-year fx risk < 10%, what risk is the pt for fractures?

low risk

30

True or False: despite being a low risk, pharmacological therapy is encouraged to prevent the progression of osteoporosis.

FALSE

typically lifestyle changes is adequate