Drug-induced metabolic bone disease.

Drug-induced metabolic bone disease via modification of resorption, formation, and mineralization is responsible for a spectrum of disorders classified as osteoporosis, osteomalacia, and adynamic bone disease. Bone disease and the coincident risk of fracture and disability are well-documented with use of glucocorticoids, L-thyroxine, ethanol, tobacco, anticonvulsants, neuroleptics, and chemotherapeutic agents. Physician awareness of these risks highlights the need for close monitoring of dosages and drug interactions and allows for intervention with nutritional support, antiresorptive agents, and proformation agents.