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Bisphosphonates define a class of drugs widely indicated since the 1990s to treat osteoporosis both in men and women. Their effectiveness in treating osteoporosis and other conditions is related to their ability to inhibit bone resorption. This activity will highlight the mechanism of action, adverse event profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions) pertinent for members of the interprofessional team in the treatment of patients using bisphosphonate drugs. Objectives: Summarize the mechanism of action of bisphosphonates. Identify the approved indications for bisphosphonate therapy. Review the potential adverse events for bisphosphonate drugs. Outline the importance of improving care coordination among the interprofessional team to improve outcomes for patients using bisphosphonate therapy for indicated conditions. Access free multiple choice questions on this topic.

Bisphosphonates are very efficacious in the prevention of fractures in patients with osteoporosis. They are relatively safe, although they do have correlations with some rare and serious adverse effects. Patient education is crucial to ensure compliance and effective treatment of osteoporosis. Patients shall receive education to eliminate other risk factors associated with osteoporotic fractures, including smoking cessation, weight-bearing exercises, avoiding excessive alcohol intake, and increasing dairy product intake.[23][24] The nursing team can assist with patient education and ensuring compliance with medications. Primary care clinicians play the most important role in identifying individuals with a high risk for osteoporosis and fractures and ensure primary prevention. Pain control and orthotic devices can assist patients who have already developed fractures.[25][26][27] Referral to specialists such as endocrinologists or rheumatologists shall be considered, especially in complicated cases. These are all examples of the kind of interprofessional teamwork necessary to manage treatment with bisphosphonates successfully. Early detection, patient education, and an interprofessional team approach can ensure better outcomes and prevent fractures in high-risk patients. [Level 5]