MOA-suppresses cytokines that stimulate osteoclasts and induces expression of Fas ligand in osteoblasts to stimulate osteoclast apoptosis

MAF-breast cancer, stroke, CV disease

Not used anymore, used for menopause symptoms

2nd/3rd line of defense

MAE-VTE

Only helps prevent fractures at vertebral level

Antiresorptive

2nd/3rd line of defense

Only prevents fractures at vertebral level, but used for pain of acute vertebral fractures

MAE-rhinitis

Use for postmenopausal osteoporosis treatment

Intranasal/IM injection

1st line of defense

Prevents vertebral, nonvertebral and hip fractures

Use when patients have renal issues***

MAE: ONJ, AFF, skin reactions

Antiresorptive

Anabolic, expensive

Only use with severe osteoporosis

MOA-stimulates both osteoblast and osteoclast activity but when given once a day in short doses it enhances osteoblast activity more

MAE: osteosarcoma

Antiresorptive, 1st line defense

Prevents vertebral, nonvertebral and hip fractures

MOA-high affinity for bone mineral which helps them to be absorbed by osteoclasts and paralyze the cell, also inhibits farnesyl pyrophosphate synthase to prevent osteoclasts from maturing

MAE-ONJ, AFF, esophageal irritation, should not be used in patients with kidney disease

Poorly absorbed when taken orally

Bisphosphonate

Have generic form

Given orally (daily or weekly)

Bisphosphonate, 1st line drug

Have generic form

Given orally or IV

Bisphosphonate

Given orally

Bisphosphonate

IV dosing

Most potent for inhibiting FPPS and has highest affinity for bone