Pathophysiology of Osteoporosis and Treatments

Osteoporosis
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Osteoporosis
Pathophysiology
The disease is secondary to the connection between multiple factors that cause the disease. It is an interconnection between intrinsic, genetic, exogenous, and lifestyle factors that increase the individual's risk of incurring the disease. Some of the endocrinologic disturbances are secondary to secondary hyperparathyroidism, estrogen deficiency, Vitamin D deficiency, and decreased oral intake. Generally, these risk factors contribute to the increase in bone resorption by the osteoclasts, which causes an imbalance in the function of the osteoblasts. Here, the latter is dysfunctional. Hence, the smaller amount of osteoblasts' average production contributes to bone fragility that will eventually lead to fractures (Föger-Samwald et al., 2020).
Treatment
Osteoporosis is common in aging women, particularly at the age of menopausal. Hence, the medications depend on the strength of the bones of the patient and the fracture risk. For individuals with moderate fracture risk and who have a previous history of fractures secondary to fragility, the following are recommended as the first-line treatment: Alendronate, Zoledronic Acid, and Denosumab. Alternatively, Ibandronate and Raloxifene may be used if the patient cannot tolerate the first-line agents. Conversely, for patients with a high risk of fractures, the physician may give Denosumab, Teriparatide, and Zoledronic Acid. The patients who cannot tolerate enteric therapy, it is best to prescribe Teriparatide, Denosumab, or Zoledronic Acid (Tu et al., 2018).
In this paper, we shall specifically focus on the first-line agent in post-menopausal women, Zoledronic Acid.
Zoledronic Acid: Mechanism of Action
This drug is classified under bisphosphonates, which act to bind hydroxyapatite. While the osteoclasts perpetuate bone resorption, it also induces local acidification. This releases the bisphosphonates that are ingested by the osteoclast through fluid-phase endocytosis. Due to this, endocytic ...