Contents:
- Medical Video: Day 1 - Appropriate Use of Drug Therapies for Osteoporotic Fracture Prevention
- Members of the bisphosphonate class
- Bisphosphonates and their side effects in the digestive tract
- The rules for taking bisphosphonate osteoporosis drugs are correct
Medical Video: Day 1 - Appropriate Use of Drug Therapies for Osteoporotic Fracture Prevention
A class of drugs called bisphosphonates are drugs used to treat and prevent osteoporosis in women who have undergone menopause and to treat osteoporosis in men. Osteoporosis itself is a condition in which the bones become thin and weak and easily broken. This osteoporosis bisphosphonate drug works by preventing bone damage and increasing bone density or thickness.
There are three osteoporosis drug dosage forms, namely in the form of tablets that are swallowed by mouth, in the form of fluids given by infusion, and in the form of fluids given by injection. The second and third giving must be done by health workers in the hospital, while giving the form of tablets can be done by the patient himself. However, this drug is not the same as other tablets, which will give a big problem if the use is not right.
Members of the bisphosphonate class
The drugs included in the bisphosphonate class include:
- Alendronate (Alovell, Osteofar)
- Risedronate (Actonel, Ristonat, Osteonate, Retonel)
- Zoledronic acid (Zometa, Zoffec, Zolenic)
- Ibandronate (not yet available in Indonesia)
Bisphosphonates and their side effects in the digestive tract
The side effect of the bisphosphonate class which is very disturbing is causing problems in the digestive tract. Side effects of the upper digestive tract such as gastric acid reflux (GERD or also known as ulcer), esophagitis, and gastric ulcer.
These side effects are associated with the local effects of bisphosphonates taken in the esophagus (esophagus) and / or gastric mucosa. However, the incidence of these side effects will decrease low if the patient follows the correct method of administration, and the risk increases in patients who cannot comply with the rules for taking medication from a doctor or pharmacist.
The rules for taking bisphosphonate osteoporosis drugs are correct
Bisphosphonates are poorly absorbed in oral administration (less than 1 percent of the dose) and must be taken on an empty stomach for optimal absorption. The following instructions are recommended to maximize absorption and minimize the risk of esophageal side effects.
1. Remember 3M principles
Minum immediately shortly after waking up early, minum on an empty stomach, andminum with a glass of water of at least 240 ml. After taking medication, patients may not consume food, drinks, drugs, or supplements for at least 1.5 hours (alendronate, risedronate) or one hour (ibandronate).
The reason for drinking 240 ml of water is to minimize the risk of the drug getting stuck in the esophagus. The reason for taking medicine on an empty stomach and waiting for 1.5 hours to eat or drink is so that bioavailability (availability of drugs in the blood) becomes high so that it can provide optimal results. This bioavailability is greatly influenced by many factors that can decrease, including:
- Fluids other than water can inhibit the action of the drug. Therefore, drugs must be taken with water, not with mineral water, coffee, tea, milk, soda or juice.
- The contents of the stomach are still stuck, for example from eating beforehand. Therefore the drug must be taken in the morning before eating or drinking anything.
- Foods or drinks that enter too soon after taking medication. Therefore, after taking medicine awaited 1-1.5 hours and were allowed to eat.
So, never take osteoporosis bisphosphonate medication before going to bed or before you get out of bed in the morning.
2. Stay standing or sit for at least 30 minutes
Another thing to note is your position when taking medication. If you take medication while standing, then stand still like the initial position (don't sit, lie down, or lie flat) until at least 30 minutes.
Similarly, if you drink while sitting, then stay seated in the same position for at least 30 minutes after administration to prevent stomach acid reflux. Don't walk, run, or lie down.
Compliance and the correct way to use the drug has an effect on reducing fractures or fractures optimally. This is illustrated in a randomized trial of nursing home residents who were assigned to minimum risedronate between meals, compared to groups who drank drugs on an empty stomach before breakfast or drinking.
After 12 weeks of observation, the group taking medication after eating did not show progress from osteoporosis. This shows how important it is to use the bisphosphonate osteoporosis medication correctly.
