OSTEOPENIA

SUBJECTIVE FINDINGS:

CHIEF COMPLAINTS:

• Low back pain since 1week.

HISTORY OF PRESENTING ILLNESS:

• A female patient of age 54years was admitted in Orthopedic ward.

• Similar Back pain six months back.

PERSONAL HISTORY:

Mixed diet.

OBJECTIVE FINDINGS:

PHYSICAL EXAMINATION:

• Moderately built
• Patient was conscious coherent and comfortable

VITAL SIGNS:

• Temperature: Afebrile.
• Pulse Rate: 80bpm
• Blood Pressure: 100/90mmHg

LABORATORY INVESTIGATION:

DEPARTMENT OF SEROLOGY:

HIV 1 AND 2 – Nonreactive

HBsAg- Non reactive

HCV- Negative

HEAMOTOLOGY ANALYSIS:
 PARAMETER RESULT REFERENCE VALUE

Hemoglobin (HGB) 8.2g/dl 14-17.5g/dl

Hemotocrit (HCT) 25.6% 42-50%
Mean Corpsuscular Volume 75.9fl/cell 80-96fl
(MCV)
Mean Corpsuscular HGB (MCH) 24.2pg/cell 27.5-33.2pg
RBC distribution Width (RDW) 18.9% 11.5-14.5%
Mean Platelets Volume (MPV) 7.9fl 6.8-10.0fl

DIAGNOSTIC TESTS:

• Bone mineral density: 1.5

ASSESSMENT:

FINAL DIAGNOSIS: Based on the subjective and objective findings the patient was diagnosed
with OSTEOPENIA.

ETIOLOGY:

Bone mineral acquisition from birth to adulthood follows a predictable trend specific to an
individual’s age and sex. With the onset of puberty, bone mineral accretion increases to its
maximum level not long after peak height gains are achieved in adolescence. Bone mineral
accretion rates remain the greatest for males and females for about four years after the peak
accretion rate is achieved, and 95% of the adult bone mass is typically achieved by age 17 for
females and 21 for males. Thus, peak bone mass is normally achieved by the third decade of life.
Failure to achieve peak bone mass as a young adult results in early onset conditions of decreased
bone mass (osteopenia or osteoporosis) and increased risk of fragility fractures even in
adolescence and young adulthood. After age 30, there is a gradual and natural bone mass
reduction that takes place over the ensuing decades into later life
 The natural bone loss that occurs gradually during adulthood is considered to be the cause of
primary forms of osteopenia and osteoporosis. Secondary causes serve to accelerate this process
and include lifestyle factors such as alcoholism, smoking, sedentary lifestyle.Caucasian and
Asian races are also established risk factors. 1

EVALUATION OF CURRENT THERAPY:

DRUGS GENERIC DOSE FRE ROA D1 D2 D3 D4 INDI SIDE

NAME Q CATI EFFE
ON CTS
Inj.Voveran DICLOFENA 1amp BD IV • • • • Analg Abdom
C esic inal
pain
Inj.Pan PANTOPRAZ 40mg OD IV • • • • Acidit Headac
OLE y he,
diarroh
oea,
stomac
h pain.
Inj.Tramadol TRAMADOL 1amp SOS IM - - - • Analg Dizzine
esics ss,head
ache.
T.Shelcal VITD3+CALI 500mg OD ORAL • • • • Enhan Increas
CUM ce ed
calciu thirst
m and
absorp urinatio
tion n
 T.MVT MULTIVITA 1Tab OD ORAL • • • • Tooth
MIN staining
,
increas
ed
urinatio
n,.
T.Stamlo AMLODIPIN 2.5mg OD ORAL    • Hypert Swellin
E ension g,
difficult
y in
breathi
ng
T.Livogen FERROUS 225mg OD ORAL   • • Iron Diarrhe
SULPHARE+I deficie a,
RON ncy Constip
anemi ation,
a. nausea,
vomitin
g

DISCHARGE SUMMARY:

• T. MVT-1tab-OD-10days.
• T. VOVERAN-500mg-OD-5days.
• T. STAMLO-2.5mg-OD-7days.
• T. SHELCAL-500mg-od-7days.

EVALUATION OF NEED FOR THERAPY:

• The prescription given is appropriate so there is no need for any other therapy for this
patient.
DRUG INTERACTIONS:

• No interactions were observed between the drugs.

PLAN:

GOALS:

• Increase the patient related quality of life.

• Maintain BP.
• Increase production of red blood cells.
• Reduce pain and improve patient condition.

PHARMACIST TREATMENT:

• Same treatment plan as prescribed by physician.

FURTHER TEST TO BE REQUIRED:

• No further test are recommended.

DRUGS TO BE AVOIDED OR CHANGED:

• The patient is responding with the physician’s treatment regimen. Hence no change is
required.

MONITORING PARAMETERS AND FOLLOW UP:

DRUGS THERAPEUTIC TOXIC PARAMETERS

PARAMETERS
DICLOFENAC is used to relieve pain, swelling Abdominal pain,
(inflammation), and joint constipation, vomiting.
stiffness caused by arthritis.
PANTOPRAZOLE Treat painful symptoms caused Headache, diarrhoea.
by conditions such as Dizziness.
gastroesophageal reflux disease.
 TRAMADOL This medication is used to help Vomiting, Dizziness.
relieve moderate to moderately
severe pain.
VITD3+CALICUM It may be used to treat Nausea, Vomiting,
conditions caused by low Constipation
calcium levels such as bone loss
(osteoporosis), weak bones
MULTIVITAMIN This medication is a Constipation, diarrhea;
multivitamin product used to nausea, vomiting, heartburn;
treat or prevent vitamin stomach pain, upset stomach
deficiency due to poor diet,
certain illnesses, or during
pregnancy.
AMLODIPINE is used to treat chest pain Swelling of ankle or Feet,
(angina) and other conditions Muscle pain.
caused by coronary artery
disease. Amlodipine is also used
to treat high blood pressure.
FERROUS Ferrous sulfate is used to treat hemolytic anemia.
SULPHARE+IRON iron deficiency anemia. ulcer from stomach acid.
burning stomach.

EDUCATION:

• Stop smoking or using tobacco.

• Avoid or limit alcohol use.
• Get regular exercise such as Brisk walking, Climbing stairs.
• Maintain a healthy diet.
• To get calcium and vitamin D, eat nonfat and low-fat dairy products such as cheese, milk,
and yogurt.
 • Some types of orange juice, breads, and cereals are fortified with calcium and vitamin D.2

REFERENCES:

1. https://www.ncbi.nlm.nih.gov/books/NBK499878/
2. https://www.webmd.com/osteoporosis/guide/osteoporosis-exercise#1

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