Osteoporosis and Fracture Prevention

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Table of Contents

Osteoporosis
Specific Goals of Therapy for J.S.
Potential Drug Therapy
The Parameters for Monitoring the Success of the Therapy
Patient Education Based on the Prescribed Therapy
Adverse Reactions of the Selected Agent
OTC or Alternative Medicines Appropriate for the Patient
Recommended Dietary and Lifestyle Changes
Drug-Drug or Drug-Food Interactions for the Selected Agent
References

Osteoporosis

A medical condition called osteoporosis weakens bones, rendering them brittle and more prone to fracture. The current study proves that women with hysterectomies are more likely than the general population to develop osteoporosis and suffer from bone fractures (Xu et al., 2022). Early therapies may help postpone or lower the risk of osteoporosis and bone breakage for these vulnerable women. Therefore, this paper details the interventions for a patient (J.S.) diagnosed with osteoporosis.

Specific Goals of Therapy for J.S.

Osteoporosis and fracture prevention are the main goals of this intervention. Osteoporosis makes bones fragile that even minor stressors like coughing or stooping can break them. Another objective for J.S. treatment is to improve bone mineral density. Normal calcium balance and a normal vitamin D status are necessary to ensure well-balanced bone metabolism, thus preventing or treating osteoporosis (Chiodini & Bolland, 2018). Finally, the therapy is crucial to reduce the side effects of the treatment.

Potential Drug Therapy

The preferred medication is a bisphosphonate, called alendronate. Bisphosphonate can decrease osteoclast activity, prevent bone resorption, and enhance bone mineral density (BMD) in individuals receiving glucocorticoid therapy (Liu et al., 2022). Generally, by lessening bone resorption caused by osteoclasts, it raises BMD. Alendronate should be used with guidance from physicians to minimize the potential side effects, including bloating, stomach ache, constipation, migraines, nausea, and gas. Finally, a mixed estrogen agonist can be given to act as hormone replacement therapy.

The Parameters for Monitoring the Success of the Therapy

Specialists can check the overall bone density and inquire about J.S’s general well-being, like whether she has joint pain or tenderness. Improved BMD following bisphosphonate medication and a decreased fracture risk with few side effects are typical measurements (Radwan et al., 2022). They can also monitor other conditions like bloating and headaches to address the side effects. Finally, since J.S. had a hysterectomy, it is crucial to assess the success of the hormone therapy.

Patient Education Based on the Prescribed Therapy

The patient should be taught to continue the therapy and exercise caution to avoid breaking bones. According to Radwan et al. (2022), the information that patients receive from healthcare professionals is a significant factor in their compliance. Any adverse effects, like a rash, difficulty swallowing, or intense abdominal pain must be reported. Finally, to prevent drug-drug or drug-supplement interactions, J.S. should inform the primary provider of any medication or dietary supplements she takes.

Adverse Reactions of the Selected Agent

Alendronate may produce certain undesirable consequences in addition to its necessary effects. Hypersensitivity reaction, uveitis, esophageal ulcers and strictures, duodenal or gastric ulceration, hypocalcemia, and osteonecrosis of the jaw are serious side effects of alendronate that may call for withdrawal. Other adverse effects included dysphagia and sore, inflamed gums (Radwan et al., 2022). Even though not all of these side effects are likely to occur, if they do, medical treatment may be required.

OTC or Alternative Medicines Appropriate for the Patient

Calcium citrate and vitamin D (cholecalciferol) are the best alternative drug for the patient. Anti-fracture effectiveness increases when calcium and vitamin D are administered in pharmaceutical doses (Iuliano et al., 2021). Calcium supplements can raise BMD in postmenopausal women and individuals at risk of osteoporosis like J.S. Calcium citrate is recommended because it is absorbed better. Nonetheless, caution must be taken to avoid potential adverse effects.

Recommended Dietary and Lifestyle Changes

Increasing consumption of a diet rich in calcium and vitamin D is one recommendation for the patient. A higher calcium intake in the diet can benefit bones in various ways (Iuliano et al., 2021). J.S. should avoid falling to minimize fractures since her bones are weaker than expected. J.S. needs to maintain a nutritious diet and exercise as much as she can. Nonetheless, she should prioritize muscle strengthening through low-impact training.

Drug-Drug or Drug-Food Interactions for the Selected Agent

Alendronate’s intestinal absorption is decreased by calcium intake; therefore, it should be used cautiously. The excessive use of alendronate or the concomitant use of other medications is connected to the frequent adverse effects (Radwan et al., 2022). Alendronate’s bioavailability is lowered by coffee and mineral water; thus, one should avoid taking beverages while on this drug. Recombinant human PTH’s calcium-sparing actions are likewise lessened by alendronate.

References

Chiodini, I., & Bolland, M. J. (2018). Calcium supplementation in osteoporosis: Useful or harmful?European Journal of Endocrinology, 178(4), 13-25.

Iuliano, S., Poon, S., Robbins, J., Bui, M., Wang, X., De Groot, L., Van Loan, M., Zadeh, A. G., Nguyen, T., & Seeman, E. (2021). Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: Cluster randomised controlled trial. BMJ, 1-10.

Liu, Z., Zhang, M., Zong, Y., Zhang, D., Shen, Z., Guan, X., & Yin, F. (2022). The efficiency and safety of alendronate versus teriparatide for treatment glucocorticoid-induced osteoporosis: A meta-analysis and systematic review of randomized controlled trials. PLOS ONE, 17(5), 1-15.

Radwan, A., Shraim, N., Elaraj, J., Hamad, A., Fatayer, D., Jarar, B., Johar, A., & Zriqah, A. (2022). Knowledge and compliance towards alendronate therapy among postmenopausal women with osteoporosis in Palestine.BMC Women’s Health, 22(1), 1-8.

Xu, W., Wu, W., Yang, S., Chen, T., Teng, X., Gao, D., & Zhao, S. (2022). Risk of osteoporosis and fracture after hysterectomies without oophorectomies: A systematic review and pooled analysis.Osteoporosis International.

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