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Pharm 1 > Osteoporosis & Hip fracture > Flashcards

Osteoporosis & Hip fracture Flashcards

1
Q

Osteopenia means

A

low bone mass

term used for thinning of the trabecular matrix of the bone before osteoporosis.

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2
Q

osteoporosis means

A

pourous bone

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3
Q

severe osteoporosis means

A

osteoporosis with Hx of a fragility fracture

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4
Q

T scores bone density

A

Normal - 1 or greater
osteopenia between -1 and -2.5
osteoporosis and severe <= -2.5

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5
Q

hos is osteoporosis measured

A

DEXA scan

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6
Q

Osteoporosis: Characteristics (4)

A

Low bone mass

Micro-architectural deterioration

Increase in bone fragility

Susceptibility to fracture

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7
Q

Major Risk Factors of osteoporosis (9)

A 
Older
Female
Asian/white
Hx fractures
family
<127 lbs
smoking
alcohol
Corticosteriods and immune suppression drugs
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8
Q

Other risk factors of osteoporosis

A 
Thin and small frame
Lack of weight bearing exercises
Lack of calcium and vitamin D
Eating disorders, gastric bypass surgery
Lack of estrogen/testosterone
Excess caffeine
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9
Q

What is bone remodeling

A

process of resorption and formation

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10
Q

What causes bone resorption or breakdown

A

osteoclasts

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11
Q

what causes bone formation

A

osteoblasts

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12
Q

ostoeporosis is caused when…

A

failure to make new bone

incresed resorption

or BOTH

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13
Q

Clinical Manifestations osteoporosis

A

+Early
None

\+Late
Fractures
Pain
Loss of height
Stooped posture
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14
Q

3 common fractures caused by osteoporosis

A

Hip : femur neck
wrist
Vertebrae: compression fracture

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15
Q

Risk Factors of hip fractures

A 
Age:  >65
Gender:  Female
Typical Medical Hx?
Osteoporosis 
Frequent falls
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16
Q

most common fracture location

A

Femoral neck

17
Q

Hip Fracture Clinical presentation

A

Sudden onset of hip pain before or after a fall

Inability to walk

Severe groin pain

Tenderness

Affected leg is externally rotated

Affected extremity is shortened

18
Q

2 Complications of hip fracture and immobility

A

infection

venous thromboembolism

19
Q

goal of pharm for osteoporosis

A

Reduce fractures

20
Q

primary prevention supplements in osteoporosis

A

Calcium

Vitamin D

21
Q

Treatment of osteoporosis

A

Promote bone formation

Decrease bone resorption** (most common)

22
Q

Osteoporosis prevention regimine

A

Calcium
Diet + supplement (elemental Calcium)= 1200 to 2000 mg daily

Vitamin D
Diet + supplement = 800 to1,000 IU daily

Women’s Health Initiative Study
30% reduction in fractures

Exercise – at least 30 min 3 x’s/week

23
Q

3 classes and drugs in treatment of Osteoporosis

A

Bisphosphonates (bis PHOS phon ates )
++Alendronate (Fosamax)

Selective estrogen receptor modulators
++Raloxifene (Evista)

Hormone therapy
++Calcitonin

24
Q

Bisphosphonate Drug

A

Alendronate (Fosamax)

25
Q

Alendronate is FDA approved for what

A

prevention and treatment

Reduces fractures by 50%

26
Q

MOA of alendronate

A

Binds permanently to surfaces of bones

Inhibit osteoclasts

27
Q

SE of alendronate

A

Most common: GI

Nausea, discomfort, diarrhea

Some risk of esophageal ulceration

28
Q

Teaching regarding alendronate

A

Take with water

Do not lie down for ½ hour after taking

No food, drink, calcium or vitamins for 2 hours (b/c only 1% bioavailability)

Drug holiday – after 5 years take a break to reduce risk of jaw necrosis and esophageal cancer

29
Q

Selective Estrogen Receptor Modulators (SERMs) Drug

A

Raloxifene (Evista)

30
Q

MOA of raloxifene

A

mimics estrogen

inhibits bone resorption

31
Q

What is the use of raloxifene

A

prevention and treatment

reduces risk of spinal fractures by 50%

32
Q

SE of raloxifene

A

hot flashes

leg cramps

33
Q

raloxifene patient teaching

A

Important to take adequate
Calcium and vitamin D

Discontinue at least 72 hrs before and during
Prolonged immobilization
Reason??

No tobacco or alcohol

Cannot use if pregnant

Black box – stroke seen in some

34
Q

Hormone: bone resorption inhibitor

A

Calcitonin-salmon (Miacalcin)

35
Q

MOA of calcitonin-salmon

A

inhibits bone removal by osteoclasts

36
Q

what is calcitonin-salmon used for

A

treatment only

Reduces spinal fractures by 30%

have to take for 5 years to see benefit

37
Q

Drug effects of calcitonin-salmon

A

Slows down bone loss

Increases spinal bone density

38
Q

SE of callcitonin

A

can cause nasal irritation

stong safety profile

Pharm 1 (28 decks)

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