Upon completion of the chapter, the reader will be able to:

1 Discuss the public health and individual concerns related to low bone mass, osteoporosis, and osteoporotic fracture.2 Explain bone physiology and pathophysiology leading to osteoporosis.3 Determine the impact of various concentrations of calcium, vitamin D, and parathyroid hormone on bone physiology and

pathophysiology.4 Identify the risk factors for osteoporosis and osteoporotic fractures for a given patient.5 Use a T-score and FRAX assessment when necessary to determine if osteoporosis treatment is needed.6 Educate a patient on improving lifestyle to maintain healthy bones and prevent further bone loss.7 Assess calcium and vitamin D intake and if inadequate create a plan to achieve adequate intakes with dietary foods and beverages

and supplements when needed.8 Explain the pharmacology, pharmacokinetics, and adverse effects of osteoporosis medications.9 Design an osteoporosis prevention and treatment regimen for a patient.

10 Adjust standard osteoporosis treatments for children, premenopausal women, older old adults, and patients with chronic kidney disease.

11 Develop patient education and counseling points regarding the use, benefits, directions, and risks of osteoporosis over the counter and prescription medications.

12 Design a monitoring plan for a patient with osteoporosis or low bone mass, including an assessment of medication adherence.13 Identify and prevent or resolve drug-induced osteoporosis, including glucocorticoid and chemotherapy-induced osteoporosis.14 Recommend and monitor vitamin D–replacement therapy for a patient with osteomalacia.

92Osteoporosis and OsteomalaciaMary Beth O’Connell and Jill S. Borchert

LEARNING OBJECTIVES