PREVENCIJA I LEČENJE GLUKOKORTIKOIDIMA IZAZVANE OSTEOPOROZE

Jasmina R Milovanović

doi:10.5937/racter10-18257

Jasmina R Milovanović Univerzitet u Kragujevcu, Fakultet medicinskih nauka, Katedra za farmakologiju i toksikologiju

DOI: https://doi.org/10.5937/racter10-18257

Ključne reči: glucocorticoids||, ||glukokortikoidi, secondary osteoporosis||, ||sekundarna osteoporoza, prevention||, ||prevencija, therapy||, ||terapija,

Sažetak

Glukokortikoidima izazvana osteoporoza je danas dobro poznati oblik sekundarne osteoporoze koja dovodi do povećanja rizika za frakture kod pacijenata, a posledično i povećanju mortaliteta i morbiditeta. Literaturni podaci pokazuju da je više od 1% svetske populacije na kontinuiranoj, oralnoj terapiji ovim lekovima. Međutim, veliki procenat pacijenata (66%) koji započinje terapiju je uskraćen za adekvatnu informaciju o dužini primene ovih lekova, njihovim neželjenim dejstvima među kojima je glukokortikoidima izazvana osteoporoza. Zbog toga je neohodno kod svakog pacijenta proceniti rizik za frakture na početku i tokom terapije glukokortikoidima. Preventivne mere je potrebno primeniti kod svih pacijenata i one uključuju opšte mere prevencije, i nadoknadu kalcijuma i vitamina D (ili njegovih sintetskih analoga) ukoliko je potrebno. Prva linija terapije podrazumeva primenu jednog od lekova iz grupe bifosfonata (alendronat, risedronat i zoledronat) koji imaju antiresorptivne efekte. Ukoliko su oni neefikasni ili pacijenti imaju visok rizik za nastanak fraktura, potrebno je uvesti teriparatid koji ima anaboličke efekte na kosti. Tokom sprovođenja preventivnih mera i terapije za ovu vrstu osteoporoze neophodan je rutinski monitoring pacijenata koji uključuje: redovno merenje mineralne gustine kostiju, procenu efikasnosti terapije kao i procenu koliko se pacijenti pridržavaju terapije (posebno tokom primene bifosfonata).

Biografija autora

Jasmina R Milovanović, Univerzitet u Kragujevcu, Fakultet medicinskih nauka, Katedra za farmakologiju i toksikologiju

Vanredni profesor

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