TY - CHAP M1 - Book, Section TI - Drugs that Affect Bone Mineral Homeostasis A1 - Jobst, Erin E. A1 - Panus, Peter C. A1 - Kruidering-Hall, Marieke Y1 - 2020 N1 - T2 - Pharmacology for the Physical Therapist, 2e AB - CASE STUDYL.T. is a 55-year-old man with a 20-year history of rheumatoid arthritis (RA) and body mass index of 28 kg/m2. He has had bilateral knee joint replacements, the most recent performed 2 years ago. L.T. ambulates with two single-point canes to increase mobility and decrease knee pain. Three weeks ago, he was diagnosed with locally invasive prostate cancer. Prior to starting pharmacotherapy for prostate cancer, he received a bone mineral density study that revealed osteoporosis. The oncologist referred L.T. to rehabilitation for development of a conditioning program as part of an osteoporosis management strategy. L.T.’s current pharmacotherapy for RA includes nonsteroidal anti-inflammatory drugs and disease-modifying antirheumatic drugs (Chapter 34) as well as long-term intermittent use of glucocorticoids (Chapter 23) during acute RA flare-ups. The pharmacotherapy for prostate cancer is designed to suppress testosterone production and destroy in situ cancer cells. Suppression of endogenous testosterone production will be accomplished by continuous dosing with goserelin plus flutamide for the first several weeks (Chapter 22). Radiation therapy will be initiated to destroy in situ cancer cells in the prostate. To help prevent further bone loss, L.T. also began taking over-the-counter vitamin D and calcium carbonate and the prescription drug alendronate. These agents are to be continued as long as goserelin is administered. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/09 UR - accessphysiotherapy.mhmedical.com/content.aspx?aid=1192817588 ER -