What is bisphosphonate therapy used for?
Bisphosphonates are drugs that help prevent or slow down bone thinning (osteoporosis). They can help to treat some types of cancer that cause bone damage. You might hear bisphosphonates called bone hardening or bone strengthening treatment. They are also a treatment for high levels of calcium in your blood.Nov 27, 2019
What is the role of bisphosphonates in patients with osteoporosis?
Bisphosphonates slow bone resorption by reducing osteoclast function. Many studies have shown that this class of medication can improve bone density and reduce the risk of fracture in patients with a reduced bone density.Apr 21, 2021
Where do bisphosphonates work?
Bisphosphonates are drugs that target areas of higher bone turnover. The osteoclast cells, which break down old bone, absorb the bisphosphonate drug. Their activity is slowed down. This reduces bone breakdown.
What is the mechanism of action for bisphosphonate?
Mechanism of action — The bisphosphonates inhibit osteoclastic bone resorption via a mechanism that differs from that of other antiresorptive agents [2-4]. Bisphosphonates attach to hydroxyapatite binding sites on bony surfaces, especially surfaces undergoing active resorption.Apr 6, 2021
How do bisphosphonates affect calcium?
Bisphosphonates decrease bone resorption by inhibiting osteoclastic activity. This is accompanied by an increase in calcium balance and in the mineral content of bone. The consequent increase in bone mass is the basis by which these compounds prevent osteoporosis in man.
What is bisphosphonate injection?
Bisphosphonates are medicines used to treat bone diseases such as osteoporosis and Paget's disease. Zoledronate (brand name Aclasta) and pamidronate (brand name Aredia) are the most commonly prescribed intravenous bisphosphonates in Australia.
How are bisphosphonates administered?
Bisphosphonates should be taken alone on an empty stomach first thing in the morning with at least 240 mL (8 oz) of water. After administration, the patient should not have food, drink, medications, or supplements for at least one half-hour (alendronate, risedronate) or one hour (ibandronate).Jul 19, 2021
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.Mar 29, 2022
What are bisphosphonates used for?
Bisphosphonates are also used in the management of hypercalcemia, Paget disease, and a number of malignancies, including multiple myeloma, breast cancer, and prostate cancer. These topics are all reviewed separately in the appropriate topic reviews.
What is the effect of bisphosphonates on osteoporosis?
Osteoporosis is caused by the cumulative effect of bone resorption in excess of bone formation. Bisphosphonates inhibit bone resorption with relatively few side effects. As a result, they are widely used to prevent osteoporotic fractures. The use of bisphosphonates for the management of osteoporosis will be reviewed here.
Can bisphosphonate cause fractures?
There is theoretical concern that prolonged bisphosphonate therapy can lead to oversuppression of bone turnover ("frozen bone") and increased skeletal fragility, resulting in atypical fracture (particularly subtrochanteric or diaphyseal fractures). The absolute risk of an atypical fracture is low.
How long after taking alendronate can you drink water?
After administration, the patient should not have food, drink, medications, or supplements for at least one half-hour ( alendronate, risedronate) or one hour ( ibandronate ). The reason for taking 8 oz of water is to minimize the risk of the tablet getting stuck in the esophagus.
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Does alendronate reduce hip fracture risk?
Alendronate, risedronate, and zoledronic acid also reduce the risk of hip and other nonvertebral fractures [ 4-6 ]. Bisphosphonates also reduce vertebral fracture in men. (See "Treatment of osteoporosis in men", section on 'Bisphosphonates' .)
Does bisphosphonate reduce BMD?
However, the addition of a bisphosphonate to teriparatide therapy provides little additional benefit for BMD, and in some studies, the addition of bisphosphonates actually reduced the increase in BMD from teriparatide. It is important to note that fracture data are unavailable for combination therapy.
What are the treatments for MRONJ?
Currently, regenerative materials widely used for the treatment of MRONJ include BMP and APC. BMP-2, a group of signaling molecules that belongs to the superfamily of transforming growth factor-β (TGF-β), has been used in orthopedic and maxillofacial surgery to increase bone remodeling.
What is an oral rinse?
Antibacterial oral rinse, medication with antibiotics and pain-killers, surgical treatment including open debridement/resection for long-term control of symptoms and infection. Open in a separate window. 2.2.
What is a MRONJ?
Medication-related osteonecrosis of the jaw (MRONJ) is one of the most interesting diseases in the field of maxillofacial surgery. In addition to bisphosphonates, the use of antiresorptive and antiangiogenic agents is known to be the leading cause. However, the exact pathogenesis of MRONJ has not been established, ...
What are the adverse effects of antibiotics?
Possible adverse events from long-term use of antibiotics consist of gastrointestinal events, end-organ toxic effects, multidrug-resistant organism colonization, and Clostridium difficile infections [54,55].
What is systemic medication?
Systemic medication, including antibiotics and pain-killers when indicated. 1. Exposed necrotic bone or intraoral fistula with no symptoms and no infection. Patient education, oral antibacterial rinse, close clinical follow-up .
What is the mechanism of MRONJ?
Another hypothesis for the pathophysiological mechanism of MRONJ is an oxidative stress-related theory. Oxidative stress refers to tissue damage caused by the loss of balance between reactive oxygen species (ROS) within tissue/cell and antioxidant mechanisms, resulting in a relatively excessive production of ROS.
Where do MSCs come from?
MSCs are generally obtained from bone marrow or adipose tissue in adults, but they also exist in various other tissues [143]. MSCs have been mainly applied in the form of grafts to verify the therapeutic potential of MRONJ, and MSC grafts have obtained good results in mice, pigs, and humans [144,145,146].