Zusammenfassung
Eine Vielzahl unterschiedlicher Medikamente greift als „Nebenwirkung“ in den Knochenstoffwechsel und -umbau ein und verursacht Knochenschwund und Mineralisationsstörungen bis hin zu Osteonekrosen. Diese Formen der Knochenschädigung werden bisher als Arzneimittelnebenwirkung in Klinik und Praxis noch zu wenig beachtet und v. a. auch nicht mit den Patienten besprochen. Präventive Maßnahmen werden vor Einsatz des Medikamentes nicht bedacht, und selbst bei Auftreten der Knochenschäden werden therapeutische Strategien nur mangelhaft umgesetzt. Auch die Frakturheilung mit ihrem komplexen, phasenhaften Ablauf kann durch zahlreiche Medikamente sowohl negativ als auch positiv beeinflusst werden und bedarf einer Kontrolle. Vorschläge einer praxisnahen Vorsorge und Therapie der medikamenteninduzierten Osteopathien werden abschließend vorgestellt.
Abstract
A number of drugs can have “side effects” on bone metabolism and formation, causing bone atrophy, impaired mineralisation, as well as osteonecrosis. In both clinical and general practitioner settings, these forms of bone damage have been hitherto considered as adverse drug side effects and have received insufficient attention; moreover, they have not been the subject of patient information. Preventive measures are not instigated prior to initiation of medication and even after onset of bone damage, therapeutic strategies are poorly implemented. Even fracture healing with its complex, staged course can be both positively and negatively influenced by a number of drugs and these effects require monitoring. Recommendations regarding practical screening and therapy of drug-induced osteopathies are presented.
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Bartl, R., Bartl, C. & Gradinger, R. Medikamenteninduzierte Osteopathien. Orthopäde 38, 1245–1261 (2009). https://doi.org/10.1007/s00132-009-1436-4
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DOI: https://doi.org/10.1007/s00132-009-1436-4