Makindo Medical Notes"One small step for man, one large step for makindo" |
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Related Subjects: | Calcium Physiology | Bisphosphonates | Osteoporosis | Osteonecrosis of the Jaw
The World Health Organization (WHO) classification of osteoporosis is widely adopted and is based on the measurement of Bone Mineral Density (BMD), with reference to the number of standard deviations (SDs) from the BMD of an average 25-year-old woman (T-score).
Treatment | Drugs | Indications | Side Effects | Doses |
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Bisphosphonates | Alendronate, Risedronate, Zoledronic Acid | Commonly used to increase bone density and reduce risk of fractures, especially in postmenopausal women. | Esophageal irritation, gastrointestinal issues, rare cases of osteonecrosis of the jaw, atypical femoral fractures. | Alendronate: 70 mg weekly; Risedronate: 35 mg weekly; Zoledronic Acid: 5 mg IV yearly |
Calcium and Vitamin D | Calcium supplements, Vitamin D supplements | Used to ensure adequate levels of calcium and vitamin D, crucial for bone health. | Constipation (calcium supplements), hypercalcemia, potential increased risk of cardiovascular events. | Calcium: 500-600 mg twice daily; Vitamin D: 800-1000 IU daily |
Denosumab | Prolia | Used for patients at high risk of fractures who cannot tolerate or haven't responded to other treatments. | Hypocalcemia, skin infections, dermatitis, eczema, rash, osteonecrosis of the jaw. | 60 mg subcutaneously every 6 months |
Estrogen Agonists/Antagonists | Raloxifene | Used to prevent bone loss and fractures in postmenopausal women, especially those at risk of breast cancer. | Hot flashes, leg cramps, increased risk of blood clots. | 60 mg daily |
Anabolic Agents | Teriparatide (Forteo), Abaloparatide (Tymlos) | Used in men and postmenopausal women with severe osteoporosis who are at high risk of fractures. | Leg cramps, dizziness, nausea, headache, hypercalcemia, potential risk of osteosarcoma. | Teriparatide: 20 mcg daily; Abaloparatide: 80 mcg daily |
Parathyroid Hormone Analogs | Teriparatide (Forteo) | Used for treating osteoporosis in men and postmenopausal women at high risk of fracture. | Nausea, dizziness, pain at injection site, increased risk of osteosarcoma (rare). | 20 mcg daily by subcutaneous injection (maximum duration 18 months, not to be repeated) |