Category:Bisphosphonates

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Bisphosphonates are synthetic analogues of pyrophosphate. They are used to preserve bone mineral density.

Contents

Mechanism

Due to the similarity to pyrophosphate, bisphosphonates are adsorbed onto the bone surface and become incorporated into the bone matrix. In the course of normal bone turn-over, existing bone is resorbed and new bone laid down. Osteoclasts are responsible for bone resorption, but when they 'digest' bone containing bisphophonate, they are inhibited. It preserves bone density by reducing loss of the mineral component of bone. However, excessive use can increase bone calfication, which paradoxically can increase the risk of fracture.

Indications

Side effects

  • Nausea
  • Diarrhoea
  • Abdomenal pain and distension
  • Flatulence
  • Dyspepsia
  • In long term use (> 7 years) atypical femoral stem fractures have been associated with alendronate and the potential for decreased bone healing and increasing differential fracture risk is a concern for all bisphosphonates due to their mechanism of action[1]
  • Atrial fibrillation (subject to on going analysis by regulatory agencies).
  • Uveitis (adjusted relative risk = 1.5, 95% CI 1.3 to 1.7) and scleritis (adjusted relative risk = 1.5, 95% CI 1.3 to 1.7)
  • Possibly oesophageal malignancy[2]

Oral bisphosphonates

  • Oesophageal ulceration
    • Patient needs assessment if
      • Dyspepsia
      • Heart burn
      • Pain on swallowing
      • Retrosternal pain

Nitrogen-containing bisphosphonates

Nitrogen containing iv bisphosphonates

  • Acute phase reaction with
    • Fever
    • Myalgia
    • Influenzae like symptoms

References

>Category:Bisphosphonates/Sideeffects

>Category:Bisphosphonates/Sideeffects/oral

>Category:Bisphosphonates/Sideeffects/Nitrogen containing

>Category:Bisphosphonates/Sideeffects/Nitrogen containing/iv

Pages in category "Bisphosphonates"

The following 8 pages are in this category, out of 8 total.

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B

C

E

I

P

R

Z