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The Bisphosphonates Used in the Treatment of Osteoporosis by Professor Fink

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In this Video Lecture, Professor Fink presents the Bisphosphonate Drugs used in the prevention of osteoporosis, as well as their mechanism of action and adverse effects. Reference is made to osteoclasts, necrosis of the mandible, Fosamax (alendronate), Actonel (risedronate), & Boniva (ibandronate).

On page a17 i just wanted to make speak a little bit about these drugs right here because they are especially relevant in dentistry and dental hygiene i think you’ve heard of them they they include fosamax actonel and boniva these are known as the bisphosphonates drugs they are prescribed to people as they get older especially postmenopausal women to reduce the

Probability of osteoporosis so in elderly people especially postmenopausal women they become very susceptible to reduced bone density and osteo related of osteoporosis that’s because of a drop in the estrogen hormone level after menopause up until about 15 years ago when women would approach menopause they used to prescribe estrogen hormone replacement therapy

But taking estrogen postmenopausal ii does slightly increase the risk of strokes so a lot of doctors became very reluctant to prescribe estrogen in postmenopausal women but you still have to have this you have this problem then with the drop of the estrogen hormone level after menopause around the age of 50 of developing osteoporosis and as the bones become weak

And more brittle that’s why there’s an increased risk of a broken hip which is very common in elderly people especially elderly women and a broken hip of course is an a misnomer it’s really not a broken hip or pelvis it’s a break in the femur where the neck of the femur breaks but in young so they these drugs how do they work these drugs inhibit osteoclasts now you

Remember there are osteoblast cells that increase deposition of calcium in the bones increasing bone density and there are osteo class that break down bone tissue that cause bone resorption so these drugs inhibit the osteo class reducing the bone resorption or breakdown a bone tissue to slow it down so that’s why they’re they’re important now why this is relevant

To dentistry is not only in terms of maintaining bone density of the maxilla and mandible but because of a potential heart adverse event so we know that patients who take high levels of these bisphosphonate drugs especially when taken intravenously i have an increased risk of necrosis of the mandible i might ask well who would be taking these bisphosphonates drugs

Intravenously and the answer is patients with metastatic bone cancer so patients with metastatic bone cancer do take these drugs but it can lead to problems so i would suggest you read over this article it’s pretty straightforward this is from the mayo clinic it is one of my go-to websites for a clinical information that is considered highly authoritative a good

Source they talk about osteoporosis and bone modeling and how to keep bones healthy and they talk about on page four estrogen hormone therapy which is no longer so much done and then they talk about the use of intravenous this phosphonate drugs and how they may cause or lead to necrosis of the mandible so if you look on the last penny to page nine here’s the bottom

Line is there a connection between taking fosamax and osteonecrosis can’t is it okay to take these bisphosphonates rug’s here’s the bottom line according to clinic yes it is safe fosamax is safe for the majority of people who take it but a may pose a risk of a rare jaw disorder caught osteonecrosis of the jaw in certain people who which people the majority of

Cases osteonecrosis which means the bone literally disintegrates all people with cancer who are receiving chemotherapy and had been been given intravenous bisphosphonates to treat the cancer that had spread or metastasize a small number of cases of osteonecrosis of the jaw have been reported in people taking oral bisphosphonates such as foes attack these have been

Primarily associated with active dental disease for recent mental procedures such as tooth extractions but the risk of developing osteonecrosis of the jaw did a bisphosphonate use is very low in people who will have don’t have bone cancer or major significant dental problems

Transcribed from video
The Bisphosphonates Used in the Treatment of Osteoporosis by Professor Fink By professorfink