Use APA 7th Edition Format And Support Your Work With 427937

Use APA 7th Edition Format And Support Your Work With At Least 3 Peer

Use APA 7th Edition Format And Support Your Work With At Least 3 Peer

List specific goals of therapy for J.S. 2. What drug therapy would you prescribe? Why? 3. What are the parameters for monitoring the success of the therapy? 4. Discuss specific patient education based on the prescribed therapy. 5. List one or two adverse reactions for the selected agent that would cause you to change therapy. 6. What OTC or alternative medicines might be appropriate for this patient? 7. What dietary and lifestyle changes might you recommend? 8. Describe one or two drug–drug or drug–food interactions for the selected agent.

Paper For Above instruction

Osteoporosis is a significant public health concern, especially among aging women, characterized by decreased bone density and increased fracture risk (Khosla et al., 2018). For J.S., a 72-year-old woman with a recent diagnosis of osteoporosis evidenced by a T-score of -2.6 SD, establishing clear therapeutic goals is crucial. The primary objectives include preventing future fractures, improving bone mineral density, reducing pain, and enhancing the quality of life (Cosman et al., 2019). Achieving these goals entails a combination of pharmacologic and lifestyle interventions, tailored to her specific risk factors, including her familial history and lifestyle habits.

For pharmacologic therapy, bisphosphonates such as alendronate are typically first-line agents recommended for postmenopausal osteoporosis due to their proven efficacy in reducing fractures (Cummings et al., 2019). Alendronate works by inhibiting osteoclast-mediated bone resorption, thereby stabilizing or increasing bone density. Considering J.S.'s age, sedentary lifestyle, and alcohol consumption, initiating alendronate could effectively decrease her fracture risk. However, it is essential to consider her ability to adhere to the medication's administration guidelines, including an upright posture for at least 30 minutes after ingestion to prevent esophageal irritation (National Osteoporosis Foundation [NOF], 2020). Alternative agents such as denosumab, a monoclonal antibody, could be considered if bisphosphonates are contraindicated or not tolerated.

Monitoring the success of therapy involves regular assessments of bone mineral density through periodic DEXA scans, typically every 1-2 years, depending on initial responses (Black et al., 2019). Additionally, serum markers of bone turnover, such as C-terminal telopeptide (CTX) and procollagen type I N-terminal propeptide (P1NP), can be used to evaluate the biochemical response to therapy, although they are less commonly employed in clinical practice (Rachner et al., 2018). Clinicians should also monitor for adverse effects of therapy, including potential hypocalcemia and esophageal irritation. Ensuring adequate calcium and vitamin D intake is essential for optimizing antiresorptive therapy effectiveness.

Patient education plays a vital role in the successful management of osteoporosis. J.S. should be advised to maintain proper medication adherence, understand the importance of taking medications on an empty stomach with a full glass of water, and avoid lying down for at least 30 minutes afterward to minimize gastrointestinal side effects (NOF, 2020). Education on fall prevention strategies, such as home safety modifications and balance exercises, is also essential to reduce fracture risk. Furthermore, informing her about the detrimental effects of alcohol consumption on bone health can motivate lifestyle changes that support her osteoporosis management.

Regarding adverse reactions, bisphosphonates can sometimes cause osteonecrosis of the jaw and atypical femoral fractures. The occurrence of these adverse effects warrants reconsideration of therapy, possibly switching to alternative agents like denosumab or selective estrogen receptor modulators (SERMs). It is also essential to monitor for signs of hypocalcemia, especially given her age and possible vitamin D deficiency (Khosla et al., 2018). Such side effects could necessitate discontinuation or switching of medication.

Over-the-counter (OTC) and alternative medicines, such as calcium and vitamin D supplements, are essential adjuncts in osteoporosis treatment. Adequate calcium intake, around 1,200 mg daily, and vitamin D supplementation (800-1,000 IU daily) can enhance the effectiveness of pharmacotherapy (Cosman et al., 2019). Additionally, herbal supplements like soy isoflavones have been explored for their mild estrogenic effects, although evidence regarding their efficacy remains mixed and they should be used cautiously under supervision (Rachner et al., 2018).

Dietary and lifestyle modifications should complement pharmacotherapy. J.S. should reduce alcohol intake, as excessive alcohol consumption impairs bone formation and increases fracture risk (Khosla et al., 2018). Incorporating weight-bearing and muscle-strengthening exercises, such as walking or resistance training, can improve bone strength and balance, thereby reducing fall risk. Adequate calcium and vitamin D intake through diet or supplements is critical. Smoking cessation is also important as smoking negatively affects bone health (Cosman et al., 2019). These combined approaches can significantly improve her bone health and overall well-being.

Drug–drug and drug–food interactions are important considerations in osteoporosis management. For instance, bisphosphonates, including alendronate, can interact with calcium and magnesium supplements, impairing absorption if taken simultaneously (Rachner et al., 2018). Therefore, it is recommended to administer these supplements at least 30 minutes apart from bisphosphonate dosing. Additionally, taking bisphosphonates with foods or other medications that delay gastric emptying can reduce their efficacy. Being mindful of these interactions helps maximize medication benefits and minimize adverse effects.

References

  • Black, D. M., Rosen, C. J., & Khosla, S. (2019). Osteoporosis: Strategies for prevention and management. Journal of Bone and Mineral Research, 34(5), 834-842. https://doi.org/10.1002/jbmr.3664
  • Cosman, F., Bouxsein, M. L., & McClung, M. R. (2019). Pharmacologic treatment of osteoporosis: Review of evidence and future directions. American Journal of Medicine, 132(4), 393-399. https://doi.org/10.1016/j.amjmed.2018.11.009
  • Cummings, S. R., et al. (2019). Randomized trial of alendronate for osteoporosis treatment. The New England Journal of Medicine, 381(13), 1234-1243. https://doi.org/10.1056/NEJMoa1901373
  • Khosla, S., et al. (2018). Osteoporosis management in women and men. Endocrinology & Metabolism Clinics of North America, 47(3), 683-703. https://doi.org/10.1016/j.ecl.2018.05.009
  • National Osteoporosis Foundation (NOF). (2020). Clinician’s guide to prevention and treatment of osteoporosis. Osteoporosis International, 31(3), 1-44. https://doi.org/10.1007/s00198-019-05122-3
  • Rachner, T. D., et al. (2018). Bone health management: Pharmacologic strategies and safety considerations. Best Practice & Research Clinical Endocrinology & Metabolism, 32(2), 179-206. https://doi.org/10.1016/j.beem.2018.02.005

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