Pharmacological treatment of osteoporosis

The osteoporosis is a systemic skeletal disease characterized by decrease in the bone mass and deterioration of the bone tissue. Occasion fragility bone increased with risk of fracture Y pain .

The International Association for the Study of Pain (International Association for the Study of Pain, IASP) explains that pain It is an unpleasant sensorineural and emotional experience due to a present injury.

The purpose of the treatment of osteoporosis is the prevention of fractures , decrease the pain , reduce risk factors and improve bone density greater than -2.5.

Between the recommendations general management include : intake of calcium (1200 mg / day), vitamin D (400-800 IU / day [at risk of deficiency]), exercise regular, preventive measures falls Y avoid the tobacco and the alcohol .

 

Pharmacological treatment of osteoporosis

In addition to changes in lifestyle, there are several pharmacological options. 11 studies on calcium , 8 on vitamin D and 12 on calcitriol, and other derivatives of the hormone , have concluded that the treatment with calcium It is effective in a population with a low mineral intake.

The vitamin D associated with calcium It is useful in a deficit population. The efficacy of calcitrol and other hormone derivatives is controversial. With the available evidence, the adequate intake of calcium Y vitamin D in the diet , or with supplements .

With the available evidence, the adequate intake of calcium Y vitamin D in the diet , or with supplements, if necessary, are essential for the prevention of osteoporosis .

Alendronic acid reduces the incidence of vertebral, non-vertebral and hip fractures in postmenopausal women. In men, it reduces the incidence of vertebral fractures (approved by the Food and Drug Administration [FDA]) and is the choice with risedronate and zoledronic acid in the treatment of osteoporosis secondary to the use of corticosteroids.

Bisphosphonates should be consumed fasting, their administration should be weekly orally, taken with a glass of water, half an hour before breakfast, and monthly administration, one hour before breakfast. The patient should not lie down after their intake, due to the high risk of gastrolesivity.

You must keep in mind your Adverse effects , like digestives (abdominal pain , dyspepsia, esophageal ulcer) and the metabolic (such as hypocalcemia, neurological and osteomuscular), among others.

On the other hand, the use of substitute hormone therapy (THS) has been generalized to control the accelerated loss of bone mass that occurs in the first years after menopause and as a treatment in the patient with postmenopausal osteoporosis.

Due to the increase in life expectancy the osteoporosis It has become a public health problem. Interventional techniques, such as osteocementoplastías in vertebrae and long bones such as the femur, relieving the pain , as well as improving the quality of life.

The effort must be directed to the prevention of fractures and the optimal management of these when they arise. Prevent or control the pain effectively, it will improve the quality of lifetime of our patients.


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