In general, osteoporosis occurs in women, especially in postmenopausal women. This is because post-menopause can lead to osteoporosis due to estrogen deficiency. In addition, the decrease in calcium intake due to endocrine reasons is also an important cause of osteoporosis. And as age increases, the increase in parathyroid hormone in the elderly can also lead to the occurrence of osteoporosis. Long-term calcium deficiency, malnutrition and inactivity in some people can also cause osteoporosis. However, osteoporosis caused by drugs, that is, pharmacogenic osteoporosis, may not be understood by many people.
Today, we will help you find out the drugs that can cause osteoporosis.
Glucocorticoids
Glucocorticoids are the most common cause of pharmacogenic osteoporosis. Dexamethasone, prednisone and other glucocorticoids are the most common drugs that cause osteoporosis. These drugs promote protein breakdown, inhibit its synthesis and increase calcium and phosphorus excretion, thereby reducing protein and mucopolysaccharide synthesis and causing impairment of bone matrix formation. These drugs can inhibit the activity of osteoblasts and bone production, which can reduce the number of bone trabeculae and osteoblasts, thus causing osteoporosis, mostly in children, menopausal women and the elderly, and in severe cases, spontaneous fractures can occur. Therefore, those who need to apply hormones for a long time should be given bone tonics and calcium tablets, as well as anti-osteoporosis drugs.
During the use of glucocorticosteroids, if there is unexplained and gradually increasing low back pain, joint pain or limited joint movement, which is not related to the climate, osteoporosis should be considered. At this time, you should seek medical attention and follow medical advice to gradually reduce or stop the use of hormones, or switch to other drugs.
Thyroid hormone
Thyroid hormone and growth hormone have a synergistic effect and can promote the growth and development of bones. However, excessive use of thyroid hormone can cause an imbalance of calcium and phosphorus in the body, resulting in bone decalcification and increased bone resorption, which can lead to osteoporosis. Patients should follow medical advice to use thyroid hormone in appropriate amounts, and should not overuse the drug to cause pharmacogenic osteoporosis, which is not worth the loss.
Patients with osteoporosis should be more concerned about the potential risk of osteoporosis when using thyroid hormone, and it is recommended to consult a doctor for combined calcium and vitamin D supplementation.
Heparin
Patients who have been using heparin, such as regular heparin and low molecular heparin, for more than 4 months are at risk for osteoporosis or spontaneous fractures. Heparin-induced osteoporosis often occurs in the spine and ribs. The mechanism of action may be related to its increased collagenolysis, accelerated bone resorption due to hyperthyroidism, and inhibition of bone formation. The risk of osteoporosis caused by low molecular heparin is lower than that of regular heparin.
The key to prevention is to strictly control the dose of the drug and avoid high doses and prolonged application of heparin.
Anti-epileptic drugs
Anti-epileptic drugs such as phenytoin sodium and phenobarbital, which need to be taken for a long time, can promote the degradation of vitamin D and reduce the absorption of calcium in the digestive tract, which can lead to hypocalcemia. Hypocalcemia, in turn, can reduce the patient’s bone volume by 10% to 30%, which in turn can lead to osteoporosis and spontaneous fractures. Therefore, patients on long-term antiepileptic drugs should start vitamin D and calcium supplements after 3 to 4 months of medication.
Diuretics
Diuretics such as tachyphylaxis and diuretics such as diuretics, hypotensive drugs and cardiac drugs are commonly used in the elderly. After long-term use, they can lead to a series of adverse reactions, such as fluid imbalance, electrolyte disorders, especially hypokalemia and hypocalcemia, which can lead to osteoporosis and, if fallen, extremely easy to fracture.
Proton pump inhibitors (acid-producing and stomach-protecting drugs)
The U.S. Food and Drug Administration (FDA) has issued warnings that proton pump inhibitors (PPIs), such as the commonly used omeprazole, may increase the risk of hip, wrist, and spine fractures. Most of the observed risks exist in patients over 50 years of age and in patients who are taking higher doses of PPIs or have a history of using them for more than 1 year. Therefore, we should not take our home remedies for long-term use.
Antineoplastic drugs
Many antineoplastic drugs can affect the skeletal system, for example, methotrexate causes osteoporosis by reducing osteoblast activity and increasing osteoclast production, and long-term high dose application even leads to methotrexate bone disease (bone pain, osteoporosis, compression fracture); cyclophosphamide can cause osteoblast damage resulting in bone dysplasia and affect bone metabolism; adriamycin causes bone marrow and bone cortex by inhibiting osteoblasts. thickness by inhibiting osteoblasts. Appropriate supplementation of calcium and vitamin D preparations, especially active vitamin D, can prevent osteoporosis caused by antineoplastic drugs.
