Osteoporosis Symptoms and Treatment
Describe the symptoms causes and treatment of osteoporosis., How do medications such as bisphosphonates selective estrogen receptor modulators (SERMs) and parathyroid hormone analogs help in its management?
Osteoporosis Management: Additional Medications and Approaches
- Denosumab
- Mechanism: Monoclonal antibody that inhibits RANKL, a protein responsible for osteoclast activation
- Indications: Postmenopausal women and men with high fracture risk, those who cannot take bisphosphonates
- Administration: Subcutaneous injection every 6 months
- Side effects: Hypocalcemia, infections, osteonecrosis of the jaw
- Romosozumab
- Mechanism: Increases bone formation and decreases bone resorption by inhibiting sclerostin
- Indications: Postmenopausal women with severe osteoporosis at high fracture risk
- Administration: Monthly subcutaneous injection for 12 months
- Side effects: Joint pain, risk of cardiovascular events
Monitoring and Follow-up
- Regular bone mineral density (BMD) testing to assess treatment effectiveness
- Monitoring for side effects, particularly with long-term bisphosphonate use
- Blood tests to monitor calcium levels, especially when taking parathyroid hormone analogs or denosumab
- Lifestyle changes need reinforcement through follow-up visits
Key Considerations for Treatment Selection
- Patient age and fracture history
- Risk of fractures based on clinical factors and BMD score
- Prior adverse reactions to medications
- Contraindications for certain therapies (e.g., history of venous thromboembolism with SERMs)
- Patient preferences and adherence to treatment plans
Fall Prevention and Rehabilitation
- Regular screening for fall risk factors
- Encouraging physical therapy and strengthening exercises
- Home safety modifications (e.g., removing tripping hazards, installing grab bars)
- Education on balance exercises and mobility aids
Overall Goals
- Prevent fractures and minimize disability
- Improve bone mineral density and strength
- Enhance quality of life and functional independence
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Selective Estrogen Receptor Modulators (SERMs)
- Example: Raloxifene
- Mechanism: Mimic estrogen’s effects on bones, increase BMD
- Indications: For postmenopausal women unable to take bisphosphonates
- Side effects: Hot flashes, increased risk of deep vein thrombosis
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Parathyroid Hormone Analogs
- Example: Teriparatide
- Mechanism: Stimulate osteoblast activity, increase bone formation
- Indications: Severe osteoporosis or high fracture risk
- Side effects: Hypercalcemia, dizziness APA