There are a number of possible side effects ...

In treating children who have suffered fractures, treatment which is currently the most

evidence of benefit is bisphosphonates. These chemical analogs of lasix drug side effects pyrophosphate, a natural inhibitor of mineralization of bone tissue. Later nitrogen-containing bisphosphonates inhibit the enzyme

Farnese diphosphate synthase in mevalonat path leads to disruption

osteoclasts induced bone resorption. Although there are many different bisphosphonates that are now available, which vary in strength and management,

most studies conducted in children I used. against training pamidronat. Most studies to date is

observations have been relatively few randomized controlled trials. Many of these studies in children with various conditions using changes in bone density as the primary outcome, often with

data improvements, but few have so far examined the frequency of fractures as a result. In the observational study >> << pamidronat a group of 30 children with moderate to severe AI, had an average annual increase in bone density of the lumbar spine by 42% >> << and risk reduction fractures 1. 7 percent per year. In a randomized 2-year study on the use of oral bisphosphonates olpadronate in children with OI was 31% lower risk of fractures

. Under the 38 children with OI and 18 children with cerebral palsy, use me. against pamidronat at intervals of 2-8 months >> << was associated with a lower frequency of fractures by 79 and 88% respectively. Effect of bone biopsy pamidronatu the group of children with OI treatment for 2 years showed >> << increase in cortical width by 88% increase in cancellous bone by 44% and increase trabekulyarnoy. Several other groups of patients also showed positive effects from the use of bisphosphonates on bone density and fractures

frequencies are listed in the Cochrane Review on bisphosphonates therapy in children and adolescents with secondary osteoporosis

Most of these studies have used myself. against pamidronat doses of 2-15/mg per kg per year. Intravascular bisphosphonates, such as pamidronat also effective in relieving pain associated with compression fractures of vertebrae.

There are a number of possible side effects of bisphosphonates including acute phase reaction appears at the first exhibition

and gastrointestinal disorders seen some oral bisphosphonates. They can lead to symptomatic hypocalcaemia if used where

is an existing deficiency of vitamin D and Hypothetical. They have been shown to delay healing of bone after routine

osteotomy in children with OI. There is no evidence that they threaten the longitudinal bone growth, although they have long half-life in skeleton

evidence excretion to 8 years after their termination. In this regard, there are concerns about potential teratogenic if taken for women of childbearing age, although so far

there is no evidence of this. There are new data on fractures occurring at the interface between the treated and untreated

(bisphosphonates naive) zones of long bones in children with OI. There have been numerous reports on the development of osteonecrosis of the jaw in people on bisphosphonates. It is a condition where necrotic painful lesions in the jaw show delayed healing. These reports, which today is only

was in adult people who are usually malignant tumor or poor oral hygiene and received high doses of potent >> << i. against bisphosphonates such as pamidronat or zoledronat, although there are some reports about it in the oral bisphosphonates. Bisphosphonates induced osteoporosis was also reported in a child treated properly. He received at least 2800 mg pamidronatu, more than four times more often provide a child with OI on

the same time.

These reports demonstrate the potential for serious side effects, and doctors considered her

use in children should discuss these potential risks and provide appropriate written information. Although this article has focused on medication a child with osteoporosis, it is important to recognize that

interdisciplinary approach often needed. In addition to the pediatrician who is familiar with children's disease of bone,

is a need for radiologists with experience in conducting and interpreting bone density scans in children. Physiotherapists and occupational therapy

need for rehabilitation after surgery or fracture. Contact orthopedic surgeons

often important for elective surgery to correct deformity of limbs or placing intramedullary rod in children with OI

to provide internal strength of bones, which are often destroyed. A specialist nurse is another important member

Team to ensure the educational status and treatment and liaise with schools to appropriate management

child with osteoporosis. .