Rheumatology
How long patients should take bisphosphonates
As a clinical pharmacist, you will hear more controversy about how long patients should take bisphosphonates (alendronate, etc) for osteoporosis. Many patients get put on a bisphosphonate to prevent fractures and are left on them indefinitely. But long-term use may be associated with problems, jaw osteonecrosis and atypical femur fractures. …
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Vitamin D Supplements
Take MORE vitamin D and LESS calcium!
As a nutrition support pharmacist, people are asking you if they should take MORE vitamin D and LESS calcium. This follows some recommendations by many experts... According to Vitamin D , some experts recommend that adults get 1000 IU/day of vitamin D instead of just 400 IU/day. They say that vitamin D is MORE important than calcium for bone health and has o…
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Vitamin D Supplements
Clinical points on VITAMIN D supplements in adults
RECENT DATA WILL BRING MORE CLARITY ABOUT THE ROLE OF VITAMIN D SUPPLEMENTS IN ADULTS. The year 2019 wasn't good for the sunshine vitamin (vitamin D). That's because randomized trials showed that vitamin D supplements don't benefit heart disease, various types of cancer, or diabetes, despite years of promising observational data. Plus most evidence sugge…
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Rheumatology
Management of osteoporosis when patients don't get enough benefit from a bisphosphonate
How to manage osteoporosis when patients don't get enough benefit from a bisphosphonate?! ― Reassess your treatment plan for patients who continue to have significant bone loss, or a fracture, despite being on a bisphosphonate. Continue the basics. Recommend weight-bearing exercise, adequate vitamin D and calcium , etc. Check adherence. Ab…
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Rheumatology
Approach to osteoporosis
E ssential of diagnosis ― Fracture propensity of spine, hip, pelvis, and wrist from depletion of bone matrix with subsequent demineralization. Asymptomatic until a fracture has occurred. Serum PTH, calcium, phosphorus, and alkaline phosphatase usually normal and serum 25-hydroxyvitamin D levels often low as a comorbid condition. Most common causes of osteoporosis in…
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Rheumatology
Screening and management of osteoporosis
Introduction ㅡ Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Osteoporosis itself is asymptomatic, and often remains undiagnosed until a fragility fracture occurs. An osteoporotic fracture is a fragility fracture occurring as a consequen…
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