Scenario: 22 year male with multiple myeloma presented to ER with severe facial pain. He recently received a drug from his oncologist and was told its good for bones and actually he recommend the same drug for patient's mom once a year! You examined the patient and call for maxillo-facial surgical consult.
Answer: Zoledronate (Zometa)
Zoledronate (Zometa) is a bisphosphonate. Zometa is used to prevent skeletal fractures in patients with multiple myeloma, Paget's disease and other cancers, as well as for treating osteoporosis. The standard dose for zoledronate is 4 mg to be infused intravenously over 15 min every 4 weeks in cancer patients but has been approved as a once-yearly 5 mg infusion for treatment of osteoporosis!
A rare complication is osteonecrosis of the jaw. Risk is higher if such patients require dental workup. Jaw bone damage and death occurs as a result of reduced local blood supply (avascular osteonecrosis). Severe cases require surgical removal of the affected bone.
