50years old), calcium
supplements (1000-1200mg/day)
Diet/Nutrition
Adverse effects include N/V, abdominal pain, esophageal irritation.
Take on empty stomach (b/c poorly absorbed).
Extended duration of action, can be taken weekly.
Treatment Pharmacotherapy Biphosphonates
Osteoporosis Alendronate (Fosamax):
Inhibits osteoclasts activity
Risk Factors
Prevention Pathology Etiology Diagnostics
Depends on how much bone
mass is achieved b/w ages
of 25-35 then after on how
much bone mass is lost. Modifiable risk factors:
Nutrition (low calcium and vit d) Imbalance b/w bone Primary, can be type 1 DEXA Scan (dual energy X-ray Screening purposes,
Acidosis renewal (osteoblasts) (associated w/menopause) or absorptiometry) measures bone density in ultrasound transmits
& bone resorption type 2 (associated spine & hips. Scores used (T-scores). sounds waves through
Low BMI , 20 @ increased risk
Substance abuse (osteoclasts). w/decreasing bone formation heel of foot to measure
Unmodifiable risk factors: due to aging). Secondary is a bone density.
Sedentary lifestyle
Female, result of disease process or
Being thin or having deficiency d/t drug (renal
small frame hypercalciuria most common
Hx of fracture after cause-treat w/thiazides diuretics
age 50 Walking or weight Score b/w (-1) - (-2.5) low Scores < (-2.5)
Gender, family hx, age. bearing exercise helps bone density (osteopenia) indicates
Smoking decreases Diameter of bone
Ethnicity, chronic diseases and bring blood flow to osteoporosis
blood supply to bone increases, thinning out
current low bone mass bones and stimulates supporting cortex.
and slows osteoblast
osteoblast growth. Cancellous bone (spongy
activity in bone renewal.
& decreases calcium bone) thins out as
Age, medication, nutrition (low
absorption Alcohol trabeculae is lost. Thin to
White & Asian women more at the point where minimal calcium & vit D intake), physical
suppress bone
risk(women bone loss starts stress will fracture bone. exercise (not enough weight
formation (toxic effect bearing exercise to stimulate bone
earlier than men at age 30)
on osteoblasts) during
maintenance). Lifestyle choices;
intoxication. excess caffeine consumption,
alcohol, smoking and lack of
exposure to sunlight reduces
Osteoporosis is more common in osteogenesis
Caucasian and Asian population.
Clinical Manifestations:
-loss of height (vertebral collapse)
Low calcium intake leads body to -kyphosis (curvature of spine)
compensate by taking calcium from -low back pain
bone > weakening bone tissue. High -fractures of forearm, spine or hip
intake of diet soda with high -silent
phosphate content can deplete disease b/c s/s are note apparent until fracture
calcium stores. happens or patient gets radiologic studies
Acidosis can result form
high protein diet
Calcium may be drawn May stimulate
from bone as kidneys try osteoclasts function
to buffer acid