The musculoskeletal system performs one of the main functions in the human body. It is she who is the support for all organs. The condition of the bones plays an important role in this. When there are malfunctions in the joints, spine, frequent fractures occur, the quality of human life is significantly reduced. One of these diseases, which is often accompanied by similar symptoms, is osteoporosis.
If you see a doctor in time, then there is the opportunity to significantly improve the patient's condition. Bisphosphonates are currently used to treat osteoporosis. These drugs can inspire hope for recovery. Let's see what kind of drugs.
What are bisphosphonates
This group of drugs got its name because of the content of two phosphonates in the structure. The mechanism of action was effective due to the enormous similarity with pyrophosphonates, which have a great effect on the regulation of calcium in the bones.
Having a similar structure, bisphosphonates inhibit enzymes that could utilize pyrophosphonates. They seem to bind calcium ions and draw them back into the bone tissue.
The positive side of taking such drugs is that preparations containing bisphosphonates only have a selective effect on the skeletal system, where calcium accumulates.
Because of this action in the treatment of osteoporosis, it is possible to prevent the loss of calcium and phosphorus, which has a positive effect on the treatment.
Varieties of bisphosphonates
Many still do not know about bisphosphonates. What it is? The third generation of this group of drugs has already been developed. Doctors continue to use drugs of the first two generations. Now many drugs basically contain bisphosphonates, all of them can be divided into two large groups:
- Simple, nitrogen free.
- A group of bisphosphonates, which include nitrogen - aminobisphosphonates.
The difference between the two groups is that they have different effects on osteoclasts.
Nitrogen-containing bisphosphonates
What it is? These funds in their composition contain the following substances:
- Ibandronate acid belongs to the third generation, synthesized recently, with great success is used to prevent osteoporosis in women, especially during menopause.
- Zolendronic acid selectively affects bone tissue, has a well-defined antitumor effect. Based on this substance, drugs such as Zometa and Zolendronate are produced.
- Sodium alendronate is a non-hormonal corrector of bone metabolism, contributes to the formation of the correct bone structure.
- Sodium ibandronate, on the basis of which they produce: Bonviva, Boniva, Bondronat, inhibits the activity of osteoclasts, but does not affect their number. These bisphosphonates for the treatment of osteoporosis are quite effective, especially as a prophylactic during menopause in women.
It must be borne in mind that you should not self-medicate, the medicine should be prescribed by a doctor.
Simple bisphosphonates
Nitrogen-free preparations of bisphosphonates for osteoporosis are also actively used. These include:
- Etidronate in the form of tablets and injections. Often it is prescribed not only for osteoporosis, but also for Paget's disease, hypercalcemia, which occurs against the background of cancer.
- "Clodronate" is available in the form of capsules, tablets and solutions. Effective in osteoporosis and osteolysis.
- Tiludronate is usually prescribed only to adults suffering from Paget's disease. It is contraindicated in children.
It is generally accepted that these two groups of drugs have different effects on the female and male body, so nitrogen-containing medications are better for beautiful ladies. In any case, the choice should be made only by your doctor.
The effectiveness of drugs for various diseases
There is a whole list of diseases in which therapy with bisphosphonates can give a positive effect.
- Osteoporosis.
- Myeloma
- Deforming osteodystrophy.
- Primary hyperparathyroidism.
- Violation of the process of bone formation.
- With metastases in the bones.
For each of these diseases, only the doctor prescribes the drug, its dosage and duration of use. Practicing self-medication can only harm the body.
Mechanism of action
Since the preparations of bisphosphonates in osteoporosis are most used, it is necessary to find out the mechanism of their action.
All cells of our body are periodically updated, the same can be said about bone tissue. In it, balance is maintained with the help of osteoblasts, which are responsible for the synthesis of new tissue, as well as osteoclasts, which are responsible for its destruction. So, BF somehow miraculously slow down the work of osteoclasts, and in some cases even start the mechanism of their self-destruction.
It is worth saying that at present, scientists have not been able to fully figure out how bisphosphonates manage to block the destruction of bone tissue. It is only known that these drugs can combine with hydroxyapatite areas in the bones, as a result of which the bending of the bone tissue changes.
It can also be noted that while bisphosphonates have been used for the treatment of osteoporosis for a long time, then cancer therapy uses them relatively recently.
Bisphosphonates for metastases
With the development of cancer , such a stage occurs when the cancer cells break away from their primary focus and spread throughout the body. In a new place, they attach and begin to grow, forming metastases.
Bone tissue is constantly updated, therefore, the likelihood of infection by hematogenous route increases. When cancer cells enter the bone marrow, they disrupt the normal interaction between osteoclasts and osteoblasts, which leads to abnormal development of bone tissue.
Since it is difficult to determine the presence of metastases, since in the first stages this process proceeds almost without symptoms, cancer patients must undergo a thorough examination to identify secondary foci.
Among all treatment methods for metastases, bisphosphonates are widely used. These drugs are fairly easily tolerated by patients, they rarely give side effects.
They can be combined with radiation and chemotherapy. Using such drugs, a decrease in the incidence of bone metastases in breast cancer and myeloma was revealed .
When hypercalcemia develops, which is almost the norm for oncological diseases, the most effective drugs are injections and infusions. An excellent result was shown by such drugs as Zolendronova acid, Pamidronate. A few days after the start of treatment, the tests show the normalization of calcium in the blood, and the effect can last up to several days.
Special recommendations for taking bisphosphonates
If you have not heard about bisphosphonates, what is it, the doctor will tell. Acceptance of these drugs should be carried out according to some rules:
- It is necessary to take medicine after waking up, at least one hour before a meal.
- Drink plenty of water.
- Do not use other liquids for washing, for example, juice, tea, coffee. They interfere with the absorption of bisphosphonates.
- After using the pill, you can’t go to bed, you need to be upright for about an hour and a half so that the effect on the esophagus is minimal.
- It is not recommended to combine the use of BP with preparations of calcium, magnesium, iron and aluminum.
If you follow all these recommendations, then taking bisphosphonates will not bring unwanted side effects.
Bisphosphonates in osteoporosis: pros and cons
In the treatment of bisphosphonates from osteoporosis are widely used. The drugs are equally successfully used in both men and women. The main advantages of these drugs include:
- Hormone free.
- Do not contribute to the development of cardiovascular diseases.
- Malignant tumors do not progress with the use of BP.
But in any barrel of honey you can always find a fly in the ointment. Bisphosphonates, despite their effectiveness in the treatment of osteoporosis, are still far from perfect. Excessive enthusiasm for their intake can give the following side effects:
- Negatively affect the liver and kidneys.
- If they are administered intravenously, then the development of hypocalcemia is likely.
- An ulcer of the esophagus or stomach may occur.
- Rashes appear on the body.
- Some have general weakness, malaise, and nausea.
- Muscle pain.
- Vision problems.
- Diarrhea or diarrhea.
It cannot be argued that all these undesirable effects will necessarily manifest themselves in each patient, but it is necessary to know about them. If you are prescribed bisphosphonates, what is it, the doctor will explain, he will choose the dosage of the drug and the duration of treatment.
Such medicines are quite effective in the treatment of osteoporosis, as well as other diseases. Before prescribing a medicine, the doctor will definitely conduct an examination to find out the state of metabolism in bone tissue and calcium homeostasis, so you should not prescribe yourself drugs of this group.
In order not to have to resort to the help of drug therapy, it is necessary to lead a healthy lifestyle, follow all the recommendations of doctors, eat right. Only in this case your bone system will be in order.