How do bisphosphonates work to prevent and treat osteoporosis?
Bisphosphonates work by slowing down the cells which break down bone (osteoclasts). Therefore they slow down bone loss, allowing the bone building cells (osteoblasts) to work more effectively. They can help to strengthen bone and help to prevent it getting any weaker.
When do you start bisphosphonates for osteoporosis?
Use immediately after fracture — A history of a fragility (low-trauma) fracture is an important risk factor for subsequent fracture. If a patient is not already treated, pharmacologic therapy (typically bisphosphonates) should be initiated in patients with fragility fracture to prevent subsequent fracture .
Why bisphosphonates is the drug of choice for osteoporosis?
Bisphosphonate therapy normalizes bone turnover, reduces the number of bone remodeling sites and stress risers, restores the balance of bone remodeling, prevents bone loss and deterioration of bone structure and, in patients with osteoporosis, reduces fracture risk (5).
Do bisphosphonates prevent osteoporosis?
Bisphosphonates — Bisphosphonates are medications that slow the breakdown and removal of bone (ie, resorption). They are widely used for the prevention and treatment of osteoporosis in postmenopausal women.
What is the important counseling point for bisphosphonates?
The tablet should be taken with a large glass of water, and the patient should not consume any food or drink, other than water, for 2 hours after taking it. Advise the patient to sit upright for 30 mins after taking the tablet as alendronic acid can cause oesophageal irritation, ulceration and in some cases strictures.
What is the function the bisphosphonate treatment regimen?
What are bisphosphonates? Bisphosphonates are a group of drugs that work by slowing bone loss. They reduce the risk of hip and spine fractures. Bone renewal is a slow process, but in many people an increase in bone density can be measured over five years of treatment.
When should you start medication for osteoporosis?
When should osteoporosis be treated with medication? Women whose bone density test shows T-scores of -2.5 or lower, such as -3.3 or -3.8, should begin therapy to reduce their risk of fracture. Many women need treatment if they have osteopenia, which is bone weakness that is not as severe as osteoporosis.
When do you repeat BMP after starting bisphosphonates?
After starting patients on bisphosphonates for osteoporosis, wait at least 3 years before ordering a repeat dual-energy x-ray absorptiometry (DXA) scan. C: Based on a secondary analysis of a large randomized controlled trial. Bell KL, Hayen A, Macaskill P, et al.
Is medication necessary for osteoporosis?
In general, if your 10-year fracture risk is at least 3% for hip fractures or at least 20% for other major osteoporotic fractures, you should consider taking medication to prevent bone loss or increase bone density to avert future fractures.
Does reclast improve bone density?
Fosamax and other drugs such as Actonel, Boniva, and Reclast increase bone density and help prevent and treat osteoporosis and/or reduce the risk of fractures.
How can you prevent osteoporosis?
Prevention of osteoporosis
- have a healthy and varied diet with plenty of fresh fruit, vegetables and whole grains.
- eat calcium-rich foods.
- absorb enough vitamin D.
- avoid smoking.
- limit alcohol consumption.
- limit caffeine.
- do regular weight-bearing and strength-training activities.
How are bisphosphonates used in the treatment of osteoporosis?
DOI: 10.1016/j.amjmed.2012.06.023 Abstract The amino-bisphosphonates are first-line therapy for the treatment of most patients with osteoporosis, with proven efficacy to reduce fracture risk at the spine, hip, and other nonvertebral skeletal sites.
Which is the best first line treatment for osteoporosis?
Bisphosphonates should be used as first-line pharmacologic treatment for osteoporosis. A. 16, 26. In patients who cannot tolerate or whose symptoms do not improve with bisphosphonate therapy, teriparatide (Forteo) and denosumab (Prolia) are effective alternative medications to prevent osteoporotic fractures.
Can a bisphosphonate decrease the BMD of a patient?
Nevertheless, the finding of a significant decrease in BMD in a patient taking bisphosphonates should prompt an evaluation for possible contributing factors, such as poor adherence to treatment, poor absorption, inadequate calcium or vitamin D intake, or development of a disorder that contributes to bone loss.
How long do bisphosphonates last in the body?
In contrast to other antiresorptive agents, bisphosphonates with the greatest binding affinity to bone (zoledronic acid > alendronate > ibandronate > risedronate) may persist in bone, and patients continue to be exposed to the pharmacologic effects of these drugs several years after discontinuation. 8 10 11