fracture risk in meds, CHF/a-fib

Omeprazole

In the past few weeks, three medications have been linked to increased risk of fractures in older adults – levothyroxine (for hypothyroidism), proton pump inhibitors (for GERD), and bisphosphonates (ironically prescribed to treat osteoporosis).

Additionally, it was reported recently in Circulation: Heart Failure that people with heart failure are at risk for vertebral fractures, with an increase when combined with a-fib.

A few thoughts with all this recent news on fractures (and seeing patients with one or more):
First, I’m glad this information is out there, and hopefully patients and their physicians and pharmacists will assess “are all these medications needed and in this dose considering the side effects?” Second, this is a reason to take a good medical history and know what your patient is taking. This segues into #3, which is the importance of weight bearing exercise which can help reduce the risk of fractures. I wish my patients and our community at large were more adherent to physical activity recommendations, but that is a research project for later.

Photo credit: Omeprazole, originally uploaded by idleman

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