The patient is concerned because her mother and sister developed fractures in their legs and vertebra after menopause. She wants to know what medication and other advice will prevent osteoporosis. You discuss bisphosphonates. How are they used in the prevention and treatment of osteoporosis?
In summary, bisphosphonates are medications that are used to prevent and treat osteoporosis by inhibiting bone resorption and decreasing the risk of fractures. Alendronate is one of the bisphosphonates that is commonly used and has been shown to increase bone mineral density and decrease the risk of vertebral fractures in postmenopausal women. However, oral bisphosphonates must be taken with caution as food and other substances such as coffee, orange juice, calcium, magnesium, and iron can decrease their absorption and bioavailability. Therefore, they should be taken first thing in the morning, on an empty stomach, with a full glass of water. In addition, individuals taking bisphosphonates should take calcium and vitamin D supplements, avoid calcium, mineral supplements, antacids and other substances that can interfere with the absorption of oral bisphosphonates at least 2 hours after bisphosphonates. A healthy diet and regular weight-bearing exercises, as well as avoiding alcohol and smoking are also important lifestyle measures that can promote bone health.

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