Osteoporosis

Flashcards for Osteoporosis Lecture Review

Osteoporosis

A disease where bones are fragile, weak and susceptible to breaking, often underdiagnosed and undertreated.

Minimal Trauma Fractures (MTF)

Fractures resulting from falls from standing height or less, coughing, sneezing, or bending over.

Risk factors for osteoporosis

Increasing age, female gender, history of falls, family history, height loss, medications like glucocorticoids, low calcium/vitamin D, smoking, alcohol, low physical activity, prolonged immobility.

Drugs that affect bone homeostasis

Glucocorticoids, excessive thyroid hormone replacement, SSRIs, long-term heparin, PPIs, aromatase inhibitors.

Drug therapies for osteoporosis

Bisphosphonates, denosumab, teriparatide, romosozumab, estrogen, raloxifene, tibolone.

Bisphosphonates mechanism of action

Inhibits osteoclastic bone resorption by attachment to hydroxyapatite binding sites on bony surfaces, reducing osteoclast activity and promoting apoptosis.

Denosumab mechanism of action

Total human IgG2 mAb that selectively binds to RANKL, inhibiting its interaction with RANK, preventing bone resorption.

Teriparatide

Synthetic of human parathyroid hormone that increases osteoblast survival and number, leading to new bone growth.

Romosozumab

Dual action drug, anabolic and anti-resorptive, reduces fractures, but requires a anti-resorptive agent.

Requirements before starting Denosumab

Vitamin D > 50nmol/L and Calcium > 2.2mmol/L