Bones

Question 1

When are bisphosponates indicated? (3)

Answer 1

1. Osteoporotic fractures
2. Myeloma and breast cancer with mets
3. Paget’s disease (aims to reduce bone turnover and pain)

Question 2

What do bisphosphonates do?

Answer 2

Inhibit osteoclasts - (the cells responsible for bone resorption) - thus decreasing bones loss

Question 3

What are common side effects of bisphosphonates (2), and what are the two main risks (but rare)

Answer 3

Common - oesophagitis, also hypophosphataemia

Rare - 1. Osteonecrosis of the jaw (more likely with high dose IV therapy). Imp. to advise patient of good dental care.

2. Atypical femoral fracture - risk associated with long term usage

Question 4

How are bisphosphonates administered

Answer 4

Sitting / standing up, don’t lie down for 30 mins. Take on its own since bisphosphonates bind with calicum and their absorption is affected by milk.