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After completing this case study, the reader should be able to:
Identify the risk factors for the development of osteoporosis and use the FRAX tool to assess risk of an osteoporotic fracture.
Recommend appropriate nonpharmacologic measures for the prevention and treatment of osteoporosis.
Recommend appropriate calcium supplementation required for the prevention and treatment of osteoporosis.
Design an appropriate pharmacologic treatment regimen for the treatment of osteoporosis in postmenopausal women.
Provide patient education regarding osteoporosis and its therapy.
“I am anxious to get the results of my DXA scan. My mother is still undergoing rehabilitation in the nursing home after her hip fracture three weeks ago. I’ve heard osteoporosis can run in families, and I don’t want to experience what she is going through.”
Beverly Farland is a 65-year-old Caucasian woman with a history of COPD, hypothyroidism, and GERD. She presents to the family medicine clinic for her yearly physical and to discuss the results of her recent labs and DXA scan.
In an effort to become more active, she recently started walking around her neighborhood every day, but has to stop after 15 minutes because she is out of breath. She admits that she has a hard time remembering to take her medications faithfully. She states she uses her Combivent inhaler approximately twice a day and takes her medicines “most of the time.”
Married; G2P3; 1 ppd smoker; drinks occasionally
Reports vaginal dryness; has noticed that her height has decreased by 2″ since she was “in her prime;” reports shortness of breath with exercise; denies headache, chest pain, GI pain, or heartburn
Combivent Respimat 1 inhalation four times daily
Omeprazole 20 mg PO once daily × 1 year
Synthroid 75 mcg PO once daily × 5 years
WDWN Caucasian woman in NAD