20 - Pharmacologic Therapy

Abstract

This chapter discusses the various agents associated with pharmacologic therapy. The objective of this therapy is to reduce the risk of fractures. The basic properties of antiresorptive agents: (1) to suppress osteoclastic activity and bone turnover, (2) preserve or increase Bone Mineral Density, improve material properties of bone, and (3) preserve bone structure. The anabolic agents stimulate osteoblastic bone formation and bone turnover, increase BMD and bone mass, may improve trabecular micro architecture and bone geometry. The role of major agents with their dosage and properties are discussed. The major role of estrogen agent is the prevention of post menopausal osteoporosis. The prevention and treatment of post menopausal osteoporosis is indicated by raloxifene agent. The treatment of women with post menopausal osteoporosis over 5 years of menopause is done by the calcitonin agent. The prevention and treatment of post menopausal osteoporosis, treatment of glucocorticoid induced osteoporosis, and treatment of osteoporosis in men is indicated by alendronate agent. The prevention and treatment of post menopausal osteoporosis, and glucocorticoid induced osteoporosis is indicated by agent risedronate, but it may cause esophageal symptoms in young patients. The ibandronate agent is helpful in prevention and treatment of post menopausal osteoporosis and it reduces vertebral fractures. The treatment of post menopausal women and men with osteoporosis at high risk for fracture is teriparatide agent which may cause hypercalcemia.