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Tuesday, November 16, 2010

Know about Treatment of Osteoporosis

Posted by Prahallad Panda on 7:03 PM Comments

Osteoporosis has become common in this age of sedentary and busy life style. Most common causes of osteoporosis are inadequate sun exposure, consequent low blood vitamin D and calcium level; and lack of physical activity.
Many times patients think that they can get rid of the diseases like osteoporosis through drug treatment without changing lifestyle, which may be partially true.
However, certain things should be remembered before going for drug treatment of this condition.

If one is having a mild disease that can be controlled by;

  • Adequate physical activity.
  • Adequate outdoor activity to get sun exposure or get vitamin D supplementation in case risk of sun exposure exists for a patient.
  • Avoiding heavy alcohol and smoking.
  • Taking calcium rich foods. Calcium supplementation may be considered.
In moderate to severe disease;
  • Follow the recommendations as in mild disease.
  • Consider getting specific drug treatment for osteoporosis like; biphosphonates or specific estrogen receptor modifiers (SERM) like raloxifene.
  • Calcitonin.
  • Parathyroid hormone (teriparatide).
  • Phytoestrogens.
These drugs have some side effects that are to be understood before starting those.
Calcium; Constipation is more common with calcium carbonate.
In biphosphonates treatment there is risk of;
· Atypical bone fractures.
· Necrosis of jaw bone (Osteonecrosis), though rare, is seen 1 in 100,000 patients treated with it.
· Heartburn, acid reflux, esophageal ulceration and perforation; which are quite rare.
· Effects on fetal development are not known.
· Musculoskeletal pain
Raloxifene; An increased risk of deep venous thrombosis and pulmonary embolism approximately the same as estrogen therapy, as well as hot flashes have been associated with its use.
Calcitonin; Rhinitis has been observed in 5% excess compared with placebo. Caution is urged with Calcitonin nasal spray in renal failure.
Teriparatide; It is associated with an increased incidence of osteosarcoma in rats given high doses over an extended period. Given this concern, it should not be used in patients with a history of bony malignancy, or those at risk.
But, it is best to change life style first before embarking upon drug treatment.
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