Osteoporosis: part II. Nonpharmacologic and pharmacologic treatment.
Family physicians will frequently encounter patients with osteoporosis, a condition that is often asymptomatic until a fracture occurs. Treatment of the fracture can be initiated without further diagnostic testing. Thereafter, treatment of osteoporosis includes (1) prevention of further bone loss through weight-bearing exercise, tobacco and alcohol avoidance, hormone replacement therapy in women, and raloxifene and calcium supplementation; (2) treatment of fracture-related pain with analgesics and calcitonin; (3) building bone mass when feasible with alendronate; and (4) modifying behaviors that increase the risk of falls. Patients without fracture who are at risk for osteoporosis can also benefit from these preventive measures. Furthermore, women of all ages should be encouraged to maintain a daily calcium intake of 1,000 to 1,500 mg and to participate in weight-bearing exercise for 30 minutes three times weekly to reduce their risk of falls and fractures. Persons at risk should avoid medications known to compromise bone density, such as glucocorticoids, thyroid hormones and chronic heparin therapy.
Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Bethesda, Maryland, USA.
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South-Paul
D002116:Calcitonin / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000209:etiology / Q000628:therapy*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use
D004164:Diphosphonates; D020845:Selective Estrogen Receptor Modulators; D002116:Calcitonin