Osteoporosis Flashcards Preview

Elderly > Osteoporosis > Flashcards

Flashcards in Osteoporosis Deck (12)
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1
Q

WHO definition

A

Bone mineral density less than 2.5 standard deviations below the young adult mean density

2
Q

Risk factors

A

Older age

Female

Corticosteroid use

Smoking

Alcohol

Low BMI

Family history

3
Q

Screening tool

A

FRAX to assess 10-year risk of patient developing fragility fracture

4
Q

Assessing bone mineral density

A

Dual-energy xray absoptiometry (DEXA)

Looks at hip and lumbar spine

If either have T score <-2.5 then treatment is recommended

5
Q

First line treatment

A

Oral bisphosphonates (alendronate)

Vitamin D and calcium supplementation should be offered to all women unless confident they have adequate intake

6
Q

Alendronate side effects

A

Upper GI problems

If cannot tolerate should be offered risendronate or etidronate

7
Q

What is recommended if patient cannot tolerate bisphosphonates?

A

Strontium ranelate and raloxifene

8
Q

T score criterias

A

Less than the others for risendronate and etidronate

Strontium ranelate or raloxifene may be given based on strict T-scores

Strictest criteria for denosumab

9
Q

Bisphosphonates

A

Licensed for treatment and prevention of post-menopausal and glucocorticoid-induced osteoporosis

Ibandronate is a once monthly oral bisphosphonate

10
Q

Raloxifene

A

Selective oestrogen receptor modulator

May worsen menopausal symptoms

Increased risk of thromboembolic events

May decrease risk of breast cancer

11
Q

Strontium ranelate

A

Increases deposition of new bone by osteoblasts and reduces resorption of bone by inhibiting osteoclasts

Only prescribed by specialist

Increased risk of cardiovascular events

Increased risk of thromboembolic events

May cause serious skin reactions (Stevens Johnson syndrome)

12
Q

Denosumab

A

Human monoclonal antibody inhibits RANK ligand which inhibits the maturation of osteoclasts

Given as single SC injection every 6 months