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1 Diagnosis, Symptom and Illness Management Name Institutional Affiliation Course Title Date

2 During case presentation at your clinic, you are reviewing four women with predisposing factors for osteoporosis. Which patient is least likely to be at risk for osteoporosis? Nehineza, an overweight African American girl with a family history of uterine cancer, has the lowest risk of osteoporosis. While all of the patients shown had some risk factor for the disease, Nehineza's weight puts her at a reduced risk. Being overweight frequently results in higher estrogen levels, which can help protect against osteoporosis. Furthermore, African American women have higher bone density than Caucasian women, which reduces their risk. Densitometry results are given as T-scores, which values would be considered as osteopenia? A T-score of less than -2.5 indicates osteoporosis(Farrah & Jawad, 2020). This shows that the patient's bone density is lower than normal but not severe enough to be diagnosed with osteoporosis. Patients with osteopenia are more likely to fracture, and osteopenia is often a prelude to osteoporosis. To avoid this, lifestyle adjustments like increased physical activity and eating a healthy diet, frequently incorporated in osteopenia therapy, are required. In addition, patients may be given medication to help prevent bone density loss, which would otherwise develop into osteoporosis. After prompt analysis of your patient, you decide to institute treatment for osteoporosis. Which class medication is considered as the first-line treatment? Are there any considerations to be taken prior starting therapy? Which recommendations would you provide to the patient regarding this treatment? The first-line treatment for osteoporosis is bisphosphonate medication(Adler, 2021). This type of drug helps by inhibiting bone disintegration. Bisphosphonates can be administered either

3 orally or intravenously. Before beginning bisphosphonate therapy, it is essential to consider the medication's risks and advantages. Because bisphosphonates might cause gastrointestinal difficulties, a review of the patient's history of gastrointestinal disorders is necessary. Furthermore, the patient should be informed about the possibility of bisphosphonates increasing the risk of jaw osteonecrosis. Bisphosphonate patients are advised to take medicine with meals and to keep upright for 30 minutes after taking the medication. This reduces the possibility of gastrointestinal adverse effects. The patient should also be advised to take calcium and vitamin D supplements, as bisphosphonates might impair nutritional absorption.

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4 References Adler, R. A. (2021). Update on Rare Adverse Events from Osteoporosis Therapy and Bisphosphonate Drug Holidays. Endocrinology and Metabolism Clinics of North America , 50 (2), 193–203. https://doi.org/10.1016/J.ECL.2021.03.003 Farrah, Z., & Jawad, A. S. M. (2020). Optimising the management of osteoporosis. Clinical Medicine , 20 (5), e196. https://doi.org/10.7861/CLINMED.2020-0131

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