OSTEOPOROSIS

Definition

It is a chronic progressive metabolic

bone disease characterized by low
bone mass and structural deterioration
of bone tissue, leading to increased
bone fragility.
 Risk factors
Non-modifiable: Genetics, Asian, female, family
history, small frame, aging, post menopause
Modifiable :
 Nutrition: low calcium/ vit D intake, inadequate
calories, high phosphate intake
 Physical exercise: sedentary, low weight, lack of
weight bearing exercise
 Lifestyle choices: caffeine, alcohol, smoking, lack
of sunlight exposure
 Medications: eg. Corticosteroids, anticonvulsants,
heparin, thyroid hormone
 Comorbidity: anorexia nervosa, hyperthyroidism,
malabsorption syndrome
Pathophysiology

Normally the rate of bone deposition is

equal to bone resorption
In osteoporosis, the bone resorption is
higher than bone deposition
 
Progressively porous, brittle and fragile
 
Fracture of bone
 Clinical manifestations
 Silent disease because bone loss
occurs without symptoms
 back pain
 spontaneous fracture
 dowager’s hump or kyphosis
 Diagnostic Evaluation
 X ray
 DEXA
 Blood tests – calcium, phosphorous, 25-
hydroxyvitamin D, alkaline
phosphotase, ESR, hematocrit
 Management

Preventive measures
 Increased physical activity
 Isometric exercises
 Good body mechanics
 Daily weight bearing exercises
 Sunbath
 Drug therapy
 Supplementation of Cholicalciferol (vit D3) & Eregocalciferol
(vit D2), Calcium salts & phosphorous – should be taken after
meals or with juice high in vitamin C for complete absorption
 Bisphosphonates – eg. Risendronate, Alendronate – daily/
weekly on empty stomach, sit upright for 30 to 60 mts after
taking drug
 Calcium & vitamin D should not take at same time
 Calcitonin – inhibits osteoclasts thereby reducing bone loss
 Selective estrogen receptor modulators (SERMs) – eg.
Raloxifene
 Recombinant parathyroid hormone – eg. Teriparatide which
stimulates osteoblasts
 Nursing interventions
 Assess and manage pain
  Initiate fall precautions to prevent
injury
 Administer medications appropriately
 Assist with repositioning
 Assist with ROM activities 
 Consult physical and occupational
therapy as appropriate
  
 Cont…
 Nutrition and lifestyle educationHealthy
diet, increase calcium intake
 Exercise as tolerable in safe
environment
 Quit smoking
 Limit or avoid alcohol