NURS6521: Bisphosphonates And Osteoporosis Discussion

Want create site? With Free visual composer you can do it easy.

NURS6521: Bisphosphonates And Osteoporosis Discussion

NURS6521: Bisphosphonates And Osteoporosis Discussion

A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug

Bisphosphonates And Osteoporosis

Bisphosphonates And Osteoporosis

Oral therapy with bisphosphonates suppresses biochemical indices of bone resorption to about 50% of
baseline at one month and to a stable nadir of 50–70%
below baseline by three months (7-9). Bone formation
falls more slowly, reaching a steady state after six to
twelve months of treatment. Overall, bone turnover is
reduced to the levels seen in healthy young adults.
Bone mineral density increases modestly (2–6%)
during the first year of treatment. Values in the lumbar spine continue to increase at a slower rate for several years, while BMD in the proximal femur plateaus
after about two years of treatment (10-12). The initial
increase in BMD is a consequence of the reduced
number and depth of bone remodeling units (13).
Subsequent increase is due to a progressive increase in
the mineral density of bone, a consequence of reduced
remodeling and increasing age of the bone tissue (14).
Therapy preserves but does not increase bone volume
or restore bone structure (15,16).
In patients with osteoporosis, bisphosphonate
therapy results in clinically relevant reduction in the
incidence of vertebral and non-vertebral fractures
(including hip fractures) (10,12,17-21). Fracture protection occurs within a few months of beginning therapy (10,12,22-24) and is sustained for at least several
years (19,25). Importantly, the cycle of progressive,
multiple vertebral fractures is reduced by 77–96%
(10,18,20).
The specific mechanisms by which bisphosphonates prevent fracture are not known. The observed
effects on fractures exceed the estimates effects based
on BMD changes, and the correlation between
changes in fracture rates and changes in BMD is, at
best, modest (26). Estimates of the contribution of the
change in BMD to vertebral fracture reduction with
bisphosphonates have ranged from 17–28% (27,28),
and no differences in fracture risk reduction are
observed with different doses of individual bisphos-
Bisphosphonates
McClung
Arq Bras Endocrinol Metab vol 50 nº 4 Agosto 2006 737
phonates that cause varied BMD responses
(12,17,19,21). The time course of fracture reduction
more closely follows the effects of treatment on indices
of bone turnover than on BMD, and a significant correlation exists between the change in these markers
with therapy and fracture protection (29,30). It is likely that the direct effect of bisphosphonates — the suppression of osteoclastic bone resorption — reduces
fracture risk by decreasing the number of bone remodeling sites and stress risers, preserving or slightly
increasing bone density and maintaining bone structure (5)

 

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: 

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Did you find apk for android? You can find new Free Android Games and apps.