Term
| what is a skeletal disorder char. by compromised bone strength? |
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Definition
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Term
| what are 3 major risk factors for osteoporosis? |
|
Definition
| adv. age, race, low weight/sm. frame, vitamin deficiency, nulliparity, certain diseases, postmenopause, fam. hist., cetain meds (corticosteroids, etc) |
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Term
| def. primary osteoporosis |
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Definition
| deterioration of bone mass NOT associated with another chronic illness |
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Term
| def. secondary osteoporosis |
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Definition
| osteoporosis resulting from chronic conditions that accelerate bone loss |
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Term
| what is the most widely used bone density measuring techniques? |
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Definition
| DEXA (dual energy x-ray absorptiometry |
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Term
| list some nonpharmacologic treatments that appear effective in preventing the progession of osteoporosis |
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Definition
| calcium and vitamin D, weight-bearing exercise, no tobacco, reduced alcohol consumption, fall reducing strategies |
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Term
| list some nonpharmacological options for VCFs |
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Definition
| phy therapy, ice massage, braces, vertebroplasty, kyphoplasty |
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Term
| describe effect of HRT on osteoporosis |
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Definition
| can prevent bone loss, but will not restore mass |
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Term
| effect of HRT on postmenopausal symptoms? |
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Definition
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|
Term
| deffect of HRT on osteo fractures? |
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Definition
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|
Term
| what are the 5 pharmacologic classes used to treat VCFs: |
|
Definition
| HRTs, SERMs, bisphosphonates, calcitonin, recombinant parathyroid hormone |
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Term
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Definition
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Term
|
Definition
| premarin, prempro, premphase etc |
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Term
| how are SERMs diff from estrogen? |
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Definition
| mimics the effect in some tissues, but blocks it in others |
|
|
Term
| what are the advantages of SERMs? |
|
Definition
| effective @ preventing post menopause osteoporosis w/o causing increase in breast cancer risk - improves lipid profile |
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Term
|
Definition
| shown to cause venous thrombosis, hot flashes and cramps |
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|
Term
| what SERMs are currently avail? |
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Definition
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Term
|
Definition
| bind perm. to mineralized bone surfaces and inhibit osteoclastic activity during resorption |
|
|
Term
| advantages of bisphosphonates? |
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Definition
| effective in prevention and treatment of osteoporosis - Fosamax approved for men |
|
|
Term
| disadvantages of bisphosphonates? |
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Definition
| abdominal and musculoskeletal pain, nausea, heartburn, and irritation of the esophagus. must also be taken on empty stomach |
|
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Term
| name currently available bisphosphonates |
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Definition
| fosamax (alendronate), zoledronic acid (reclast), risedronate sodium (actonel), ibandronate (boniva) |
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Term
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Definition
| increases levels of calcium and potassium in the bones and lowers the level of calcium in the blood |
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|
Term
| advantages/disadvantages of calcitonin? |
|
Definition
| reduces risk of new VCFs and occas. relieve VCF pain - minimal risks incl diarrhea and flushing |
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|
Term
| MOA of forteo (recombinant parathyroid) |
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Definition
| can rebuild bone by stimulatings osteoblasts - is the only med that can do this; other osteo meds rely on anti-resorptive mechanism |
|
|
Term
| what are the risk of Forteo? |
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Definition
| bone cancer and little long term data - as such Forteo is only recommended for a 2 yr max duration |
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Term
| subacute back pain is described as mild to moderate and can persist for how long? |
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Definition
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|
Term
| Acute pain after a VCF will often subside after how long? |
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Definition
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|
Term
| of women with VCFs, how many gave a hist. of pain severe enuf to require a medical consultation and xray? |
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Definition
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Term
| what 4 major categories of pain meds can be used to treat VCF pain? |
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Definition
| acetaminophen, NSAIDs, prescription non-narcotic meds (cox2 inhibitors), narcotic pain meds |
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Term
|
Definition
| inhibit cox 1 & 2 enzymes (cox 2 is almost entirely responsible for inflammation) |
|
|
Term
| what is the most sig. risk with NSAIDs used over 2 mo? |
|
Definition
| peptic ulcers and gastric bleeding |
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|
Term
| T/F narcotic anagesics work indirectly on the central nervous system. |
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Definition
|
|
Term
| What is one side effect of narcotic pain meds seen in elderly populations? |
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Definition
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