Question

Is IV zoledronic acid as effective as risedronate for the treatment of glucocorticoid-induced osteoporosis?

Write a full paper on the following

. Part 1 - Introduction/Background

A. Disease state background

1. Epidemiology/frequency

2. Causes and risk factors

3. Pathophysiology

4. Signs and symptoms

B. Treatment of disease state

1. Standard of care (the standard, accepted way to treat the disease)

1. Nonpharmacologic

2. Pharmacologic

a. Usual drug therapy – what drugs are used and when are they used?

b. Role of assigned drug – where does it fit into usual drug therapy?

C. Drug information 1. Mechanism of action/drug class

2. Usual indications or uses (both FDA-approved and off-label)

3. Basic pharmacokinetic data (eg, absorption, distribution, metabolism, excretion)

4. Usual dose for given disease state/clinical situation and any adjustments for special populations

5. Key warnings/adverse events/clinically relevant drug interactions II.

Answer 1

A, glucocorticoid-induced osteoporosis:
1, Epidemiology:
It occurs in chronic glucocorticoid usage patients in 30 to 50%, fracture due to glucocorticoids are often asymptomatic.
2, Causes and risk factors:
It occurs due to the usage of glucocorticoid mediation like prednisone, dexamethasone, and cortisone. these medicines have metabolism action of calcium, vitamin d, and bone.
risk factors include age, sex, BMI, history of fracture, alcohol intake and smoking, glucocorticoid use, arthritis.
3, pathophysiology:
glucocorticoids decline of bone mineral density, it impairs the replication and function of osteoblasts and creates apoptosis of mature osteocytes and osteoblasts, it suppresses the bone formation
4, Signs and symptoms:
fracture, bone loss, low bone mineral density
B, treatment of care
1, the standard of care
1, Nonpharmacological:
Exercise, good nutrition, avoiding alcohol, smoking as a nonpharmacological interventions
2,pharmacological:
Bisphosphonates are the standards of care. injectable teriparatide or oral alendronate at daily dose stimulates bone formation and increases bone strength and decreases the risk of fracture.
a, Usual drug therapy:
Bisphosphonate for adults <40years to avoid fracture IV daily dose.
b, Zoledronic acid given once a year by IV infusion to treat osteoporosis, it is a preventive treatment for multiple myeloma and it is an antineoplastic therapy.
c, drug information
1, mechanism of action:
It increases bone density and reduces the incidence of fracture, it inhibits osteoclastic bone resorption.
2, Usual indications or use:
It treats hypercalcemia of malignancy
3, Basic pharmacokinetic data
It has a low affinity of zoledronic acid for the cellular component of human blood with plasma concentration ratio 0.59 in 30ng/ml to 5000ng/ml and it has low plasma binding with unbound fraction range.
Medication slowly released into the systemic circulation with low plasma concentration.
4, Usual dose for given disease state:
IV 5mg first yearly once recommended.
5, key warning:
Fever, nausea, abdomen pain, anorexia, anxiety, agitation, confusion, UTI, constipation, dyspnea, anemia, diarrhea.