Wh5

Non-FDA approved drug (Lasofoxifene mechanism)

Lasofoxifene: estrogen agonist/antagonist

Non-FDA approved drug (Tibolone mechanism)

Tibolone: selective tissue estrogenic regulator

FDA-approved drugs (Hormones & Minerals)

Bisphosphonates, calcitonin

FDA-approved drug (Teriparatide classification)

Teriparatide: parathyroid hormone

Alendronate brand name & oral dosing

Alendronate (Fosamax): 10 mg daily or 70 mg weekly (oral)

Bisphosphonates administration precautions

Oral or IV, take with water, stay upright 30 min

Bisphosphonates side effects (Esophageal damage)

Esophagitis, esophageal erosions, ulcers

Bisphosphonates side effects (Esophageal complications)

Perforation, stricture

Bisphosphonates drug holiday duration reason

3-5 years typical: after that → ↓ effective & risk of jaw necrosis

Bisphosphonates drug holiday consideration timing

Consider after 5 years of oral therapy if no ↑ fracture risk (T-score > –2.5, fractures free)

HRT role in osteoporosis

HRT: used for prevention, not for treatment

Agents effective against vertebral fractures

Alendronate, Risedronate, Raloxifene, Teriparatide

DEXA Scan monitoring frequency (On treatment)

Every 2 years for patients on treatment

DEXA Scan monitoring frequency (Osteopenia)

Every 3-5 years for patients with osteopenia

DEXA Scan monitoring frequency (Low-risk/Normal BMD)

Every 5-10 years for low-risk or normal BMD (after age 65-70)

Vitamin D deficiency definition level

Serum 25-hydroxyvitamin D level <20 ng/mL (50 nmol/L)

Vitamin D insufficiency definition level

Serum 25-hydroxyvitamin D level 20-30 ng/mL (50-75 nmol/L)

Vitamin D deficiency gender prevalence

More in females: 37.3% vs 5.1% in males

Vitamin D deficiency malabsorption causes

Malabsorption: celiac, IBD