A 75-year-old female patient presented with severe lower back pain and a stooped posture. Diagnostic tests revealed lumbar vertebral collapse and reduced calcium levels. She was diagnosed with osteoporosis based on her symptoms, physical examination findings, and test results. Her treatment plan included calcium and vitamin D supplements to strengthen bones, alendronate to decrease bone resorption, and counseling on lifestyle modifications like daily sunlight exposure and diet changes.

1. CASE PRESENTATION
ON
OSTEOPOROSIS
PRESENTATION BY:
IV/VI PHARM-D

2. SOAP note
A female patient of age 75 years was admitted in the hospital with
Following information;
SUBJECTIVE DATA:
Chief complaints: severe back pain persistent in the lower back region.
On examination: stooped posture is clearly observable. She is conscious
and coherent.
Patient medication history interview:
1. Are you being treated for any medical condition?
A. Yes
2. What is the medical condition and how long?
A. Asthma since 10 years.
3. What medications are you using and how do you use them?
A. Hydrocortisone 10 mg tab and Beclomethasone inhaler 200 mcg
both morning and at night

3. 4. Which route are you taking?
A. Both Oral and nasal routes
5. Did you take any OTC medications before admission?
A. Yes
6. What OTC medications did you take?
A. Paracetamol 650mg
7. Do you have any allergies/allergic to any medicine?
A. Not any
8. Did you undergo any surgery before?
A. yes
9. What is it?
A. Surgery to fix the fracture of my left wrist
10. When did it occur to you?
A. Two years ago

4. PERSONAL HISTORY AND HABITS
Height: - 140cm Weight: - 65kg BMI: - 33.16kg/m2.
Education: NA Occupation: house wife
Diet(non-veg/veg): Mixed Alcoholic/Smoker: No
Sleep: - Normal Appetite : Normal
Bowel & Bladder habits: Normal

5. OBJECTIVE DATA
O/E: Conscious, coherent
Physical examination :
Diagnostic tests:
Radiological investigations: x ray of spine: Lumbar vertebral collapse between L4 and L5
prominently at L4 vertebrae.
PARAMETER D1 D2
Temp(*F) 98.6 98.6
PR(beats/min) 96 92
BP(cycles/mm) 120/80 120/80
RR(Cycles/min 26 26

6. LABORATORY INVESTIGATIONS:
PARAMETERS NORMALVALUE D1
T . WBC 4000-11000(cells/mm ) 6,200
PLATELET COUNT 1.5-4.5(lakh/mm3) 3.58
ESR 0-22(mm/hr) 8
UREA 5-20(mg/dl)
S.CREATININE 0.7-1.4(mg/dl) 0.7
HB 12-15(g/dl) 11.9
S.POTASSIUM 3.5-5.5(mmol/l) 4.9
S.CALCIUM 2-2.5(mmol/l) 1.8
S.SODIUM 135-145(mmol/l) 143
S.ALKALINE
PHOSPHOTASE
20-140(IU/l) 120

7. DIAGNOSIS: OSTEOPOROSIS
ASSESSMENT: Based on subjective data i.e., stooped posture that
approximately decreased her height upto 10cm, lower back pain. Reduced
calcium levels in blood and the report of x ray of spine, the patient was diagnosed
with “Osteoporosis”.
.
PLANNING:
Treatment Goals:
• To increase the bone strength and rigidity through Ca ++ supplements.
• To decrease bone resorption through bisphosphonates.
• To stop the intake of oral corticosteroid for asthma management.
• To shift the patient to only nasal sprays for asthma.
• Also, check the possibility to including oestrogen based HRT(hormone
replacement therapy)in the patient.
• Try to use bronchodilators in place of corticosteroid drugs.

8. S.NO BRAND NAME GENERIC NAME DOSE ROA FREQ D1 D2 D3
1 SHELCAL Vitamin d3 200IU p/o BD   
2 PANTOP Pantoprazole 40mg IV OD   
3 CIPCAL 500 Calcium 500mg p/o BD   
4 OSTEOFOS 10 Alendronate 70mg p/o OD   
5 DOLO 650 Paracetamol 650mg p/o OD   
6 FLOHALE Fluticasone 50mcg p/o OD   
DRUG CHART

9. DISCHARGE MEDICATIONS:
1. FLUTICASONE 50mcg OD(inhaler)
2. CALCIUM 500mg OD(Tab)
3. ALENDRONATE 10mg OD(Tab)
4. PANTOP 40mg OD
5. PARACETAMOL 650mg OD (Tab)- only is pain is present
6. VITAMIN D3 200IU OD (Tab)
NON PHARMACOLOGICAL THERAPY:
PATIENT COUNSELLING:
1)Disease based counselling:
• Patient is clearly explained about her condition and its management.
• Advice is given to not skip the medications.

10. 2) Diet and life style modification:
• Daily expose to sunlight atleast 30minutes per day
• Do not consume cold beverages
• Do breathing exercises to increase the lung capacity.
• Should not do heavy physical activity and especially things like weight lifting.
3. Drug based:
• Advised to take medications regularly
• Do not consume antacids or any other OTC medications without consulting the physician.
• Take calcium and alendronate tablets on empty stomach
• Take calcium tablets atleast 30 minutes after alendronate
DRUG INTERACTIONS:
No drug interactions found