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May Chronic Treatment with Proton Pump Inhibitors Increase Risk of Fracture Resulting from Osteoporosis

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Inhibitors (PPIs) have become one of the most commonly prescribed classes of medications in the primary care setting. 14 Their ability to enable practitioners to simply and effectively treat a variety of acid-peptic diseases with minimal side-effects has placed PPIs among the major advancements in dealing with gastric conditions and disorders. Omeprazole (Prilosec) was introduced to the United States market in the year 1989, and its rapid success and longevity have led to several other PPI drug becoming readily available by prescription in the United States. The intravenous form of pantoprazole (Protonix I. ) is now available, and the U.

Food and Drug Administration (FDA) approved one of the newest PPI, esomeprazole (Nexium), in 2001. Osteoporosis is a common condition throughout the developed world, affecting up to 16% of women and 7% of men aged 50 years and older. The condition is of primary concern because of the increased incidence of fractures caused by bone degeneration. 1 The normal amount and variety of proteins and minerals in the bone is altered in cases of osteoporosis, and the standard the bone mineral density (BMD) is reduced, disrupting the bone microarchitecture itself and contributing to its structural failure.

The World Health Organization (WHO) defines the condition of osteoporosis in women as a bone mineral density 2.5 standard deviations below peak bone mass (represented by the twenty-year-old healthy female average bone mass) as measured by DXA. Osteoporosis is a gradual condition that may develop to different extents in different areas of the body and often affect bones that move or are put under constant stress more than stationary and flat bones. ‘ Established osteoporosis’ refers to cases of osteoporosis in which fragility fractures exist. 15 A fragility fracture is a traumatological term for a bone fracture that occurs as a result of a fall from standing height or less.

The three fracture sites said to be typical of fragility fractures are vertebral fractures, fractures of the neck of the femur and Colles fracture of the wrist.    

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