OSTEOPOROSIS-MANAGEMENT

SUMMARY

NON-PHARMACOLOGIC MANAGEMENT
1. Weight-bearing exercises, gait & balance training
2. Diet high in calcium
3. Sunlight exposeure for Vitamin D
4. Maintenance of good BMI
5. Avoiding cigarette smoking & excessive alcohol intake

PHARMACOLOGIC MANAGEMENT
1. Calcium supplementation
2. Vitamin D

3. Bisphosphonates: oral bisphosphonates are first line
4. Denosumab

5. Estrogen +/- Progesterone: in post-menopausal women
6. Selective Estrogen Receptor Modulators (SERM): for those who are unable to take estrogen (breast cancer risk)

7. Calcitonin

8. Teriparatide

9. Romosozumab
10. Management of secondary osteoporosis: management of hypogonadism in men with testosterone, etc.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].