Transcript WHAT IS OSTEOPOROSIS?

OSTEOPOROSIS
Ann S. Goodson,R.N.,MSN,ONC
Nurse Coordinator
Pediatric Orthopedics
University of Virginia
Bone
Is Living, Growing Tissue
• CORTICAL BONE
• TRABECULAR BONE
Bone Cells
3 Types
• OSTEOCLASTS
• OSTEOBLASTS
• LINING CELLS
• OSTEOCYTES
The Skeleton’s Function
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Support the body
Protect internal organs
Muscles attach for movement
Mineral reservoir for Calcium and
Phosphorus
• Defense against acidosis
• Trap for some dangerous minerals such as
Lead.
What is Osteoporosis?
• OSTEO= BONE
• POROSIS= FULL OF HOLES
OSTEOPOROSIS IS A STEADY,
PROGRESSIVE LOSS OF BONE DENSITY.
OSTEOPOROSIS , THE “SILENT CRIPPLER”
IS A PAINFUL BONE DISEASE THAT
MAKES YOUR BONE GROW BRITTLE
AND FRACTURE EASILY
OSTEOPOROSIS
• Re-absorption of
bone cells slowly
exceeds bone cell
formation
Schematic view of bone
formation/re-absorption
Risk Factors You
Control
Not Smoking
Exercise
Avoid alcohol
Sex Hormones
Medications
Diet
Risk Factors You Can Not
Change
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GENDER
ETHNICITY
BODY SIZE
AGE
Exercise
• Bone building
exercises
 Walking
 Dancing
 Jumping rope
 Lifting weights
Foods High in Calcium
• DAIRY PRODUCTS
• LEAFY GREEN
VEGATABLES/BROCCOLI
• SALMON ( WITH THE
BONES IN) SARDINES
• CALCIUM ENRICHED
FOODS
• ALMONDS
Recommended Daily Calcium
Intake for Males & Females
AGE
AMOUNT(milligrams per day)
Birth-6 months
210
7 months-1 year
270
1-3 years
500
4-8 years
800
9-18
1300
19-50
1000
51-+ + +
1200
Pregnant & Lactating
Same as for women of comparable
age
Diagnostics
• Osteoporosis is preventable and treatable,
therefore early diagnosis and treatment is
important.
• Most common technique is Dual Energy Xray Absorptiometry (DEXA scan)
Precise measurement/high resolution
Sensitive to changes
Simple to perform, no pain or discomfort
Less Radiation
Consequences of Osteoporosis
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Vertebral Fractures
Loss of height
Acute and chronic back pain
Morphologic changes
*kyphosis
*loss of waistline
*protruding abdomen
• Physiologic changes
*Digestive function
*Breathing difficulties
• Increased mortality
Consequences of Osteoporosis
• Nonvertebral
fractures
(Examplehip,wrist,arm)
• Pain
• Loss of
independence
• Possible entry in a
nursing home
• Surgical
complications
MEDICATIONS
Antiresorptive Agents
Name of
Medication
Description
Function
Estrogen Replacement
Therapy (ERT)
0.625 mg recommended for
women that have had
hysterectomy or oophorectomy
before age of 50
ERT helps reduce osteoclast
activity which results in a slower
rate of bone loss and increased
bone mass in the spine and hip
Alendronate &
Risendronate
•Biophosphonates used in the
treatment of bone loss associated
with the use glucocorticords.
•Dosage depends on useprevention and treatment
•Decrease bone loss
•Increase bone density
Raloxifine
•Selective estrogen receptor
modulator –produce similar
benefits as ERT without the side
effects
•Reduces the risk of spinal fractures
•Encourages the bone density
throughout the body
Calcitonin-salmon
•Synthetic compound identical
to calcitonin found in salmon
•Slow bone loss by binding to
orthoclase
•Increase spinal bone mass
•Reduce risk for spinal fracture in
postmenopausal women
Demystifying Calcium
Supplements
• Calcium supplements-1000-1500 mg per
day
• Taken in doses not > 500 mg at a time
• Elemental calcium
Calcium carbonate
Calcium citrate
Calcium Phosphate
• Vitamin D-is essential for Ca absorption
Nursing Guidelines for Osteoporosis
Prevention
• Promote widespread patient and public
education regarding osteoporosis
• Encourage safe physical activity Discourage
smoking and excessive alcohol consumption
• Promote achieving and maintaining a healthy
body weight and life styles
• Investigate safe hormone replacement
therapy
• Fall and Injury Prevention
THANK-YOU!