Bisphosphonates constitute a group of compounds and their structure is based on that of pyrophosphate:a compound that regulated precipitation and extraction of minerals from the bone, albeit they are sensitive to phosphatase hydrolysis.
Bisphosphonates change the structure through a phosphorus-carbon-phosphorus axis, which is very stable and resists enzyme hydrolysis, which thus allows a strong bound to the bone.

Bisphosphonates, thanks to their capacity to inhibit osteoclastic activity, are the standard treatment for tumor-related hypercalcemia, and they have been proven to reduce bone pain, improve quality of life, delay skeletal events, and decrease their number.

Zolendronic acid is the active ingredient of Zometa. It is an IV administered aminobisphosphonate.

Zolendronic acid is rapidly bound to the bone, inhibiting osteoclastic activity, and thus improving bone resorption. Its selective bone action is based on its great affinity for bones at remodeling phase.
Obviously, Zolendronic acid inhibits bone resorption without affecting bone formation, mineralization or mechanical properties.

Indications for Zometa:

- prevention of skeletal complications associated to the myeloma bone lesion ( pathological fractures, medullary compression, need to use bone irradiation or surgery, and tumor-induced hypercalcemia ), in patients with advanced malignancies with bone affectation;

- treatment of tumor-induced hypercalcemia ).

The recommended dose for the prevention of events related to the skeleton in multiple myeloma 4 mg of Zometa,administered as a 15-minute IV perfusion very four weeks.

Patients with cancer should be subjected to a dental revision before initiating treatment with intravenous bisphosphonates.
Avoid dental procedures while on treatment with bisphosphonates, since in patients who might develop an osteonecrosis of the jaw during the bisphosphonates treatment, dental surgery could exacerbate this situation.
In case a patient needs a dental procedure, there are no data available suggesting that the interruption of the treatment with bisphosphonates reduces the risk of osteonecrosis of the jaw.

Source: Medicina Oral Patologia Oral Y Cirugia Bucal, 2007

XagenaMedicine2007


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