Osteoporosis Flashcards
Risk factors for osteoporosis
-post menopausal women
-men 50+
pt taking long term oral glucocoticoids
-age +
-vit D + CA+ deficiency
-lack of exercise
-low BMI
smoking + drinking
-history of fractures
-early menopause
what is osteoporosis
progessive bone disease
-reduction of bone mass and density causing increased risk of fractures
lifestyle changes for osteoporosis
-inc exercise
-smoking cessation
-maintain ideal BMI
-lower alcohol intake
-inc intake of vit D + CA+ supplements
when should osteoporosis tx be reviewed
after 5yr
-3yr for zoledronic acid
1st line tx of osteoporosis
-oral bisphosphonates (alendronic/risedronate)
alternate tx for postmenopausal osteoporosis
-ibandronic acid, denolumab, raloxifene, strontium
-younger postmenopausal = HRT or tibolone
- terparatide = severe osteoporosis
alternate tx for men with osteoporosis
zolendronic acid
denosasumab
teriparatide
strontium
alternate tx for glucorticoid induced osteoporosis
zoledronic acid
dersosumab
teriparatide
glucocrticoid induced osteoporosis
when should you start prophylaxis at onset of glucocortoid tx?
-women
->70+, previus fragility fracture, large dose (pred >7/5mg OD or eq)
-men
->70+ and or previous fragility fracture, large dose
-> large dose corticosteroid 3MT+
what are the MHRA warnings for bisphosphonates?
-atypical fermoral fractures
-osteonecrosis of the jaw
-osteonecrossi of external auditory canal
MHRA WARNING
what symptoms should you report with atypical fermoral fractures
Thigh, hip or groin pain
MHRA WARNING
what symptoms should you report with osteonecrosis of the jaw
dental pain
swelling
non-healing sores or discharge
MHRA WARNING
what symptoms should you report with osteonecrosis of external auditory canal
ear pain
discharge
ear infection
what are the s.e of bisphosphonates
oesophageal reactions
REPORT and STOP: oseophageal irritation, dysphagia, heartburn
how to avoid oseophageal reactions with bisphosphonates
take medicine with full glass of water whilst standing = remain upright 30 mins after
