osteoporosis, menopause and testosterone use Flashcards
osteoporosis is very common in which class of people
postmenopausal females
what medications can cause osteoporosis
anticonvulsants
aromatase inhibitors
depo medroxyprogesterone
gnRH
lithium
PPIs
steroids
thyroid hormones
others such as heparin, loop diuretics ssris TZDs
osteoblasts
make bones
osteo clast
breaks bones
how to diagnose osteoporosis
Bone mineral density measurement
DEXA scan
W>65 should measure
M>70 should measure
FRAX kinda like ASCVD for bones
T score
compares average BMD of a healthy, young adult to that of the same sex
-1 is normal
-1 to -2.4 is low bone mass (osteopenia)
< -2.5 osteoporosis
what medications should be careful to avoid fall risk in low density
sedations and orthostatis
antihypertensive, hypnotics, sedatives, analgesics
vit D defeciency causes
defeciency in VIt D causes rickets and osteomalacia
calcium carbonate vs citrate
Carbonate> citrate
** more than 500mg doses should be split
** citrate has better absorptionn with increased gastric pH
VITD tx
high dose VIT D2 ergocalciferol
VIT D3 cholecalciferol (sunlight)
for 8-12 weeks
25-50mcg (1000-2000 units)
calcium recommended daily
1000-1200mg
carbonate has 40% elemental calcium (acid dependant)- take with meals
citrate 21%
VIT D dose daily
tx- 125-175mcg (5k-7k) daily or
1250mcg (50k weekly)
what does osteopenia mean
T score -2.4 and FRAX score >20% or 10year hip fracture >3%
what does osteoporosis mean
T score <-2.5 with or without fracture
drug tx for osteoporosis
Bisphosphonates= 1st line
denosunab
teriparatide /abaloparatide
raloxifene/bazedoxifene/estrogen
estrogen or calcitonin not recommmend
