Other drugs for osteoporosis

• Introduction.

• Classification of Osteoporosis drug.

• Dose of Osteoporosis drug.

• Mechanism of action 

• Examples of Osteoporosis drug

• Causes of Osteoporosis drugs resistance

• Toxicity of osteoporosis drug

• Monographs

1-Introduction.

Osteoporosis drugs are medications used to prevent and treat osteoporosis, a condition that weakens bones and makes them more susceptible to fracture.

3-Dose of Osteoporosis drug.

The defining dose, or the standard recommended dose, for osteoporosis drugs can vary depending on the specific medication and factors like your individual needs. Here's why it's important to talk to your doctor:

Medications have different potencies: A 60mg dose of denosumab (Prolia) achieves a different effect than a 70mg dose of alendronate (Fosamax). There's no single "defining dose" across the board.

Individual needs vary: Your doctor will consider factors like your age, weight, kidney function, and other medications you're taking when determining the right dose for you.

However, I can provide some general information about typical dose ranges for some common osteoporosis drugs:

Bisphosphonates: These come in various forms (daily, weekly, monthly) with a range of potencies. For example, alendronate (Fosamax) might be a 70mg weekly dose, while zoledronic acid (Reclast) is a one-time yearly infusion.

Denosumab (Prolia): This is typically a 60mg injection given subcutaneously (under the skin) every 6 months.

Teriparatide (Forteo): This comes as a daily injection, usually at a dose of 20mcg.

4-Mechanism of action

Osteoporosis drugs work by targeting the two main processes that contribute to bone loss: bone resorption and bone formation.

• Anti-resorptive drugs: These medications reduce the activity of osteoclasts, the cells responsible for breaking down bone tissue. This helps to slow bone loss and increase bone mineral density (BMD).

• Anabolic drugs: These medications stimulate the activity of osteoblasts, the cells responsible for building new bone. Anabolic drugs are less commonly used than anti-resorptive drugs, but they can be helpful for people with severe osteoporosis or who cannot tolerate anti-resorptive drugs. 

5-Examples of Osteoporosis drug

1. Denosumab

2. Teriparatide

3.  Calcitonin

6-Causes of Osteoporosis drugs resistance

Resistance causes of osteoporosis drugs 

Osteoporosis drugs, while very helpful, can develop resistance in some cases. Here's a breakdown of the potential causes:

• Reduced Drug Effect Over Time:  With long-term use, some antiresorptive medications, like bisphosphonates, might become less effective in preventing bone breakdown. This doesn't necessarily mean complete resistance, but rather a need for a different approach.

• Incomplete Adherence:  If you don't take your medication exactly as prescribed (missing doses, stopping early), it reduces the drug's ability to consistently regulate bone turnover. This can lead to a perception of resistance.

• Underlying Medical Conditions:  Certain medical conditions, like kidney disease or gastrointestinal issues, can affect how your body absorbs or processes osteoporosis drugs. This can hinder their effectiveness.

• Biological Variations:  Everyone's body reacts differently to medications. In some cases, individuals might have a natural resistance or slower response to certain drugs, requiring alternative treatment options.

7-Toxicity of osteoporosis drug

• Osteoporosis drugs, while effective in strengthening bones, can have potential side effects  we should be aware of. Here's a look at the toxicity of some common osteoporosis medications:

• Antiresorptive Medications:

• Bisphosphonates: These are widely used, but potential side effects include:

• Upper gastrointestinal problems: Heartburn, nausea, and stomach ulcers can occur, especially if not taken with a full glass of water and while sitting upright.

• Atypical femoral fractures: This is a rare but serious complication, particularly with long-term use.

• Jaw problems: Osteonecrosis of the jaw (ONJ) is a potential side effect, though uncommon.

• Denosumab: This injection medication can cause:

• Skin infections: There's a slightly increased risk of skin infections at the injection site.

• Low calcium levels: Monitor for symptoms like muscle cramps or numbness.

• Bone-Building Drugs:

• Teriparatide: This injectable medication can cause:

• Leg cramps: These are usually mild and temporary.

• Dizziness: Talk to your doctor if this persists.

• Romosozumab: This injectable medication carries similar risks as teriparatide, including:

• Leg cramps

• Dizziness

• Abaloparatide: This injectable medication shares some potential side effects with teriparatide and romosozumab, such as:

• Leg cramps

• Dizziness

• High blood pressure: Monitor your blood pressure regularly.

• Monographs