Question

a.) Siphokazi, a 50-year old post-menopausal female, has been admitted to the emergency room after tripping over a step. She broke a few toes, but the doctor believes it will heal well. He does investigate and ultimately diagnoses her with osteoporosis, which contributed to her fall. Suggest a drug which would be appropriate to treat her osteoporosis, and explain how it would facilitate this. (3)

b.) Siphokazi has been compliant with her treatment for several months, though has started to experience pain in her leg with localised swelling. Her doctor fears that she has developed a deep vein thrombosis. Discuss the way in which her anti-osteoporosis treatment may contribute to the development of deep vein thrombosis. (4)

c. )Siphokazi’s physician prescribes her rivaroxaban as treatment for the deep vein thrombosis in combination with aspirin. The treatment proceeds well, and she experiences few side effects. During a gym detox challenge, she is requested to drink at least two glasses of grapefruit juice daily. Grapefruit juice is a potent CYP3A4 inhibitor, with effects that may last for up to three days after ingestion. Regarding her deep vein thrombosis, i) explain how rivaroxaban will treat her condition, and ii) discuss the potential consequences of drinking grapefruit juice while treating her condition.

Answer 1

a, Medication for osteoporosis prevention for postmenopausal women is important. after menopause level od estrogen reduces that increase the incidents of bone breakdown. long term hormone treatment therapy treat menopausal women bone loss.
Alendronate increases bone density. risedronate reduces the fracture risk due to osteoporosis.estrogen drugs increase bone density and reduce the incidence of fracture. Ibandronate prevents a certain type of bone loss.
b, Antiosteoporesis medication causes side effects like bone, joint, and muscle pain and also had a risk for the thromboembolic incident with various effects of drugs. Oral hormone therapy cause hepatic effect so it increases proinflammatory factors and synthesis progestin amplifies the risk of cardiovascular disease. when estrogen produces paradoxical action on endothelium(vascular walls) that cause the breakdown of plague in the blood vessels and hypercoagulability.
c, Rivaroxaban recommended for treating DVT and prevent recurrent DVT without any symptoms of pulmonary embolism after completion of initial treatment for 6months.
Grapefruit juice blocks the action of CYP3A4.many drugs breakdown with vital enzymes CYP3A4. it causes the drugs to stay in the blood for a long period it makes too much drug in your body. it provides potential benefits with drugs by preventing metabolization.