Advanced Pharmacotherapeutics. prescribers case studies

Woo Page 1 of 1 Pharmacotherapeutics 5e Ch21 Student CS Chapter 21: Drugs Affecting the Bones and Joints

Student Case Study

A menopausal patient has completed her dual energy x-ray absorptiometry (DEXA) scan, which

shows early osteopenia. She knows her mother had the same issue and was started on

bisphosphonates right away to prevent further decline. She requests similar care. She can’t drink

milk because she is lactose intolerant. She considers herself a couch potato and has a sedentary

job at work. She takes proton pump inhibitor (PPI) meds for her incessant heart burn due to her

moderate obesity and has been on thyroid supplements since high school. She was on Depo-

Provera for less than 2 years during her early college days. She has had two tripping-related

nondisplaced fractures of her wrists in the past 2 years that have healed well. She does have the

need for some major dental work this year.

1. What other pharmaceutical interventions have possibility contributed to her diagnosis?

2. Are there any assessments or interventions concerning these medications that might result in

an improved bone health picture?

3. What about her request to start bisphosphonates now that she is becoming osteopenic?

4. What about her calcium intake and lactose intolerance?