Biphosphonates
Biphosphonates
Biphosphonates, also known as bisphosphonates, are a class of drugs that prevent the loss of bone density. They are commonly used to treat osteoporosis and similar diseases. These medications are structurally similar to pyrophosphate, a naturally occurring compound in the body that inhibits bone mineralization.
Mechanism of Action[edit | edit source]
Biphosphonates work by inhibiting osteoclast-mediated bone resorption, which in turn leads to an indirect increase in bone mineral density. Osteoclasts are cells that break down bone tissue, and by inhibiting their activity, biphosphonates help to maintain or increase bone strength.
The drugs bind to hydroxyapatite found in bone, and when osteoclasts attempt to resorb bone that contains biphosphonates, the drugs are released and taken up by the osteoclasts. This uptake disrupts the osteoclasts' ability to function, leading to apoptosis (programmed cell death) of these cells.
Clinical Uses[edit | edit source]
Biphosphonates are primarily used in the treatment of:
- Osteoporosis: To prevent fractures in postmenopausal women and men at high risk.
- Paget's disease of bone: To regulate bone remodeling.
- Bone metastases: To reduce skeletal-related events in patients with cancers such as breast cancer and prostate cancer.
- Hypercalcemia of malignancy: To lower high calcium levels in the blood associated with cancer.
Common Biphosphonates[edit | edit source]
Some of the commonly prescribed biphosphonates include:
- Alendronate (Fosamax)
- Risedronate (Actonel)
- Ibandronate (Boniva)
- Zoledronic acid (Reclast, Zometa)
Side Effects[edit | edit source]
While biphosphonates are generally well-tolerated, they can cause side effects, including:
- Gastrointestinal issues such as esophagitis, gastric ulcers, and abdominal pain.
- Osteonecrosis of the jaw, particularly in patients receiving high doses for cancer treatment.
- Atypical femoral fractures with long-term use.
- Acute phase reactions, such as fever and muscle pain, especially with intravenous administration.
Administration[edit | edit source]
Biphosphonates can be administered orally or intravenously. Oral biphosphonates should be taken with a full glass of water on an empty stomach, and patients should remain upright for at least 30 minutes to reduce the risk of esophageal irritation.
Also see[edit | edit source]
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