Week 12 Case Study: Osteoporosis
J.S., a 72-year-old woman of Asian descent, has just transferred to your practice. She had a hysterectomy 8 years ago and has not been on hormone replacement therapy. She is 5 ft 2 inches tall and weighs 102 lb. She has had a sedentary lifestyle (she was a secretary and retired 2 years ago). She drinks four glasses of wine a day. Her mother died at age 62 from complications of a hip fracture. J.S.’s sister was just diagnosed with metastatic breast cancer. You prescribe a DEXA scan, and the T-score is −2.6 SD.
1. 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.