Anti-osteoporosis medication recommendations after fracture
According to the “Osteoporosis Fracture Treatment Guidelines” of the Chinese Medical Association Orthopaedic Branch, there are several main points as follows.
1. Reasonable use of calcium
The calcium requirement is 800-1200 mg, and the dose of calcium supplementation after fracture should be increased appropriately. It is recommended to take it in several doses.
2. Recommended active vitamin D3
The recommended usage is 0.25-0.5 μg/d, which not only enhances intestinal calcium absorption, promotes bone formation and bone mineralization, but also helps to enhance muscle strength, improve neuromuscular coordination and prevent the tendency to fall.
Pay attention to regular monitoring of blood calcium or urine calcium.
3.Calcitonin
Calcitonin can increase bone density, improve bone quality, enhance the biomechanical properties of bone, reduce the incidence of vertebral osteoporotic fractures, and have an analgesic effect.
However, a small number of patients may have facial flushing, nausea and other adverse reactions, most of them can be relieved within a few hours, and those with obvious drug allergy history are prohibited.
4.Biphosphonates
Such as alendronate sodium, risedronate sodium, zoledronate sodium, etc., can improve the lumbar spine and hip bone density, reduce the risk of fracture and the incidence of re-fracture. Alendronate is available in 70 mg/w and 10 mg/d orally and should be taken with a glass of plain water 30 min before the first meal of the day, not with mineral water.
To reduce the irritation of the stomach and esophagus, avoid lying down for at least 30 minutes after taking the drug. The main adverse effects of bisphosphonates are gastrointestinal reactions, such as nausea, vomiting, abdominal pain, diarrhea, etc.
5.Selective estrogen receptor modulators (SERMs)
Such as raloxifene 60 mg/d, the duration of dosing is not affected by diet. It has good efficacy in improving bone density and reducing the incidence of postmenopausal osteoporotic fractures.
A small number of patients may experience hot flashes and lower extremity cramps during dosing. It is contraindicated in perimenopausal women with severe hot flashes and is contraindicated in those with a history of venous embolism and a tendency to thrombosis (e.g., prolonged bed rest, sedentary).
6.Strontium salt
Such as strontium ranelate 2 g/d, taken at bedtime. Has a dual mechanism of action to improve bone strength and reduce the risk of vertebral and hip fractures.
Common adverse reactions are headache, nausea, diarrhea, loose stools, dermatitis, eczema, etc. Use with caution if you have a history of venous embolism.
How to prevent
1. Quit smoking and limit alcohol, and eat a balanced diet.
2.Maintain moderate body weight.
3.Muscle strength exercise and whole body balance and coordination exercise.
4.Outdoors activities, increase sunlight.
5.Take measures to prevent falls.
6.Preventive and correct use of medication.