Name of the Procedure:

Injection, teriparatide, 10 mcg
Common Name(s): Teriparatide Injection
Technical/Medical Term: Recombinant Human Parathyroid Hormone 1-34 Injection

Summary

An injection of teriparatide, which is a form of parathyroid hormone used to treat patients with certain conditions that weaken bones. It helps to increase bone strength and density.

Purpose

Medical Conditions:

• Osteoporosis in postmenopausal women
• Osteoporosis in men at high risk of fractures
• Osteoporosis due to prolonged use of systemic glucocorticoid therapy

Goals:

• Reduce the risk of fractures
• Increase bone mineral density
• Enhance bone strength

Indications

Symptoms or Conditions:

• Severe bone loss detected via bone density scans
• History of fractures related to osteoporosis
• High risk of fractures due to long-term steroid use

Patient Criteria:

• Adults with significantly low bone density (T-score of -3.5 or lower)
• Patients who have failed or are intolerant to other osteoporosis therapies

Preparation

Pre-Procedure Instructions:

• Review of medical history and current medications
• Patients may need to adjust their calcium and vitamin D intake
• No specific fasting required

Diagnostic Tests:

• Bone mineral density test (DEXA scan)
• Blood tests to assess calcium levels

Procedure Description

1. Preparation: The patient’s skin is cleaned with an antiseptic wipe.
2. Injection: Using a pre-filled pen, 10 mcg of teriparatide is injected subcutaneously (under the skin), commonly in the thigh or abdomen.
3. Monitoring: The patient is observed for any immediate reactions post-injection.

Tools & Equipment:

• Pre-filled teriparatide injection pen, antiseptic wipes

Anesthesia: Not required; local pain management techniques may be offered if needed.

Duration

The injection itself takes only a few minutes.

Setting

This procedure is typically performed in an outpatient clinic or at home after initial training by a healthcare provider.

Personnel

Healthcare Professionals Involved:

• Primary care physician or endocrinologist
• Nurses for initial instruction
• The patient may self-administer the injection after receiving proper training

Risks and Complications

Common Risks:

• Injection site reactions (redness, pain, swelling)
• Leg cramps
• Dizziness or lightheadedness

Rare Risks:

• Allergic reactions
• Elevated calcium levels

Management:

• Monitoring and managing calcium levels
• Providing antihistamines or other medications if allergic reactions occur

Benefits

Expected Benefits:

• Increased bone density within 3-6 months
• Reduced risk of fractures
• Enhanced overall bone strength

Recovery

Post-Procedure Care:

• Monitoring for any side effects
• Adjusting lifestyle to include safe physical activities to strengthen bones

Recovery Time:

• No downtime; normal activities can be resumed immediately
• Regular follow-ups with healthcare provider every few months

Alternatives

Other Treatment Options:

• Bisphosphonates (e.g., alendronate, risedronate)
• Denosumab (another injectable medication)
• Hormone replacement therapy for women

Pros and Cons of Alternatives:

• Bisphosphonates: less frequent dosing, but potential for gastrointestinal side effects
• Denosumab: effective but requires biannual injections
• Hormone therapy: beneficial for menopausal symptoms but with risks such as increased cancer risk

Patient Experience

During the Procedure:

• Mild discomfort from the injection
• Possible immediate site reactions (redness, slight swelling)

After the Procedure:

• Possible mild side effects such as dizziness or cramps
• Pain management includes over-the-counter pain relievers if necessary
• Regular monitoring of calcium levels and bone density will be necessary to track progress