bisphosphonates inhibit the resorption of bone by osteoclasts and may have an effect on osteoblasts. They are structurally similar to pyrophosphate, a normal product of human metabolism. This structure gives the drugs a high affinity for bone and they probably remain in bone for many years.
Bisphosphonates can reduce progression of osteoporosis by inhibiting the resorption of bone.
A once-yearly iv bisphosphonate which is given as a 5mg iv infusion (1st infusion should be given usually in a hospital) to Mx osteoporosis in patients with osteoporotic fractures (not to be confused with the 4mg monthly infusions to Rx hypercalcaemia in malignancies).
Similar adverse event profile to oral bisphosphonates but less oesophageal/GIT adverse effects.
Thus there may be a role for ED short stay units to be giving 1st iv infusion for those patients who cannot tolerate oral bisphosphonates or do not wish to take weekly doses of these, and who have an osteoporotic fracture. Oral bisphosphonates must be ceased, and max. of 3 infusions over 3 years permitted on PBS.