Which combination of medications is associated with an increased risk of osteoporosis?

Which combination of medications is associated with an increased risk of osteoporosis?

• A. Ranitidine, Thiazolidinediones (glitazones)
• B. Metformin
• C. Alendronate
• D. Calcium carbonate

Answer: (A)

Medications can influence bone health by affecting how bone is built and maintained. Thiazolidinediones activate PPAR-γ in bone and shift mesenchymal stem cells away from becoming osteoblasts (the cells that form bone) toward becoming fat cells. This reduces bone formation and can lead to weaker bones and more fractures, especially in older individuals. If you add a medication that lowers stomach acidity, like ranitidine, calcium absorption can be less efficient because calcium carbonate needs stomach acid to dissolve properly. So this combination can compound the risk: impaired bone formation from the thiazolidinedione plus potentially reduced calcium availability from the acid-suppressing drug, both contributing to osteoporosis risk. Metformin generally does not increase fracture risk and may be bone-neutral or even beneficial in some contexts. Alendronate and calcium carbonate, on the other hand, are used to prevent or treat osteoporosis and would not be expected to raise fracture risk.

Medications can influence bone health by affecting how bone is built and maintained. Thiazolidinediones activate PPAR-γ in bone and shift mesenchymal stem cells away from becoming osteoblasts (the cells that form bone) toward becoming fat cells. This reduces bone formation and can lead to weaker bones and more fractures, especially in older individuals. If you add a medication that lowers stomach acidity, like ranitidine, calcium absorption can be less efficient because calcium carbonate needs stomach acid to dissolve properly. So this combination can compound the risk: impaired bone formation from the thiazolidinedione plus potentially reduced calcium availability from the acid-suppressing drug, both contributing to osteoporosis risk. Metformin generally does not increase fracture risk and may be bone-neutral or even beneficial in some contexts. Alendronate and calcium carbonate, on the other hand, are used to prevent or treat osteoporosis and would not be expected to raise fracture risk.