Vitamin D Supplements
Vitamin D deficiency in adults
Introduction ㅡ Vitamin D deficiency is characterized by hypocalcemia and/or hypophosphatemia and rickets in children and osteomalacia in adults. When interpreting a vitamin D level, you are really asking, “Is this vitamin D level adequate to meet my patient’s needs?” The problem is that some patients may have a greater or lesser need for vitamin D than others. We…
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Vitamin D Supplements
What you need to know about VITAMIN D
Now that so many more people are taking vitamin D, some are asking how much vitamin D is too much. Explain that vitamin D doses vary widely and toxicity is rare... TO PREVENT DEFICIENCY, recommend 1000 to 2000 IU/day of vitamin D for adults and 400 IU/day for infants and children. Most people will need supplements. We don't get much vitamin D from the sun th…
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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
Using calcium supplements safely
As a pharmacist, you will hear more debate about whether calcium supplements are safe. New evidence suggests these supplements are linked to dementia. But this is mainly in elderly women who've had a stroke and does NOT prove that calcium supplements cause dementia. Plus, previous concerns about calcium supplements and cardiovascular (CV) risk may be waning. A re…
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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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