A 62-year-old postmenopausal woman with osteoporosis presents with progressive lumbar back pain for three months. Her blood pressure is 118/74 mmHg and BMI is 23 kg/m². BMD T-score is -2.8 at the lumbar spine, and serum calcium is 9.1 mg/dL. Physical examination reveals mild midline thoracic tenderness without neurologic deficits. She has a first-degree family history of breast cancer and denies vaginal bleeding or breast symptoms. Previous hormone replacement therapy caused abnormal uterine bleeding, which she wishes to avoid. She seeks a medication that reduces vertebral fracture risk and lowers breast cancer risk without endometrial stimulation. Which of the following drugs best meets these therapeutic goals?
- A)Calcitonin
- B)RaloxifeneGABARITO
- C)Teriparatide
- D)Tamoxifen
- E)Alendronate
Explicação
Raloxifene is a selective estrogen receptor modulator that acts as an estrogen agonist in bone and antagonist in breast and endometrium. It can improve bone density while reducing breast cancer risk without the endometrial stimulation seen with tamoxifen. Ver explicação completa e trilha adaptativa →