Osteoporosis+and+bone+health

=__ **OSTEOPOROSIS AND BONE HEALTH** __=

Most chemotherapeutics reduces bone mineral density (BMD) and increases risk for fractures by causing gonadal suppression, which in turn increases bone removal. This rapid rate of bone destruction makes it difficult for the body to keep up with production of new bone to replace it. This condition is manifested by a stooped posture, loss of height, back pain related to fractured or collapsed vertebrae and commonly occurring fractures. Its most commonly diagnosed by a DEXA scan, or dual energy x-ray absorptiometry.
 * Pathophysiology:** Osteoporosis occurs when the rate of bone production cannot keep up with the rate of bone absorption, causing decreased bone density. Cancer patients receiving chemotherapy have an increased risk of developing osteoporosis.

**Nursing Interventions: **
 * //Prevention //
 * Adequate intake of Calcium, Vitamin D and weight bearing exercise (as tolerated) can decrease the risk of Osteoporosis - at least 1200mg of Calcium and 800-1,000mg of Vit. D.
 * Dietary Modifications, consume foods high in Calcium such as dairy products, dark leafy greens, tofu, salmon, and sardines (with bones)
 * Avoid tobacco smoking and alcohol consumption
 * //Patient Education//
 * Explain all tests and procedures
 * Teach patient ways to prevent falls and injuries- wear proper fitted shoes, remove clutter, install bars in showers and tubs, avoid walking on icy paths alone
 * //Assessment//
 * Check the patient's skin for areas of warmth and redness, assess for new pain sites
 * Monitor pain level and response to treatment
 * //Provide emotional support and reassurance//


 * Drug therapy:**
 * Biophosphonates - calcium regulation and bone resorption inhibitor
 * Alendronate (Fosamax)
 * Risedronate (Actonel, Atelvia)
 * Ibandronate (Boniva)
 * Zoledronic Acid (Reclast, Zometa)
 * Synthetic Hormones - stimulates new bone formation
 * Teriperatide (Forteo)
 * Calcitonin, salmon (Fortical) Estrogen Replacement therapy for Women
 * Human Monoclonal antibody - inhibits osteoclast activity and production
 * Denosumab (Prolia)
 * Analgesics to relieve pain

MedScape []
 * //__References:__//** Mayo Clinic [] U.S. National Library of Medicine []