OSTEOPOROSIS

BONE Bones are rigid organs that form part of the endoskeleton of vertebrates.

Functions: Movement

Support

Protect various organs of the body

Production of blood cells

Store minerals

Disorders of bone:

Bone fracture Osteomyelitis Osteoarthritis Osteoporosis

WHAT IS OSTEOPOROSIS?

Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones.

It leads to abnormally porous bone that is compressible, like a sponge.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength.

This disorder of the skeleton weakens the bone and results in the frequent fractures in the bone.

The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis.

EPIDEMIOLOGY

Fractures - over 1.5 million annually caused by osteoporosis in the USA.

Vertebrae fracture - approximately 700,000 vertebral (spinal) fractures annually in the USA.

Hip fracture - about 300,000 hip fractures due to osteoporosis annually in the USA.

Wrist fracture - about 250,000 wrist fractures in the USA.

Types of osteoporosis:

Primary osteoporosis:

The condition is caused by age-related bone loss.

Usually in people after the age of 70.

Secondary osteoporosis:

The loss of bone mass is caused by lifestyle factors, diseases or medications.

Causes: Hypogonadism alcohol abusehypercalciurea immobilization

• At the top is the normal Bone

• Effected by osteopenia showing lack of calcium

• Severe case of osteoporosis

CAUSES:

Thin and small body frame

Family history of osteoporosis

Smoking

Low testosterone levels in men (hypogonadism)

Chemotherapy

Chronic inflammation, due to chronic diseases such as rheumatoid arthritis or liver diseases

Hyperthyroidism

Vitamin D deficiency

Excessive alcohol consumption

Diet low in calcium

Malabsorption

SIGNS & SYMPTOMS: Fracture

Swelling

Joint pain

Disfigurement

Debilitation

Kyphosis (is a common condition of a curvature of the upper back.)

DIAGNOSIS: A routine X-ray can reveal osteoporosis of the bone because the bones appear much thinner and lighter than normal bones.

Bone mineral density test that can measure the strength of your bone.

Often blood tests are used to measure calcium, phosphorus, vitamin D, testosterone, and thyroid and kidney function.

Ultrasound .

PATHOGENESIS

PREVENTION Lifestyle changes

curtailing excessive alcohol intake

exercising regularly

consuming a balanced diet with adequate calcium and vitamin D.

MEDICATIONS BIOPHOSPHONATES :

GENERIC NAME TRADE NAME

• Alendronate

• Ibandronate

• Zoledronic acid

• Fosamax

• Boniva

• Reclast

CALCITONIN:

RALOXIFENE:

GENERIC NAME TRADE NAME

• Calcitonin • Cibacalcin

GENERIC NAME TRADE NAME

• Raloxifene • Evista

Biophosphonates: Alendronate (Fosamax)

Ibandronate (Boniva)

Zoledronic acid (Reclast)

MODE OF ACTIONThis class of medicines slow the rate of bone thinning and can lead to increased

bone density. Bisphosphonates’ mechanisms of action all

stem from their structures' similarity to pyrophosphate. A bisphosphonate group

mimics pyrophosphate's structure, thereby inhibiting activation of enzymes that utilize

pyrophosphate.

PHARMACOKINETICS

Of the bisphosphonate that is resorbed (from oral preparation) or infused (for

intravenous drugs), about 50% is excreted unchanged by the kidney. The remainder

has a very high affinity for bone tissue, and is rapidly adsorbed onto the bone surface.

Side effects:

Heartburn, abdominal pain, and irritation of the esophagus.

Headache and pain in muscles and joints.

Calcitonin Cibacalcin

MODE OF ACTION

It helps to regulate calcium levels in your body and is part of the bone-building process.

Calcitonin is potent inhibitor of osteoclastic bone resorption.

Calcitonin inhibits bone resorption and slows down rate of bone loss.

Side effects: Runny nose or nasal discomfort. Nausea. Skin redness (flushing).

Raloxifene (Evista)

MODE OF ACTION Evista (raloxifene) reduces the amount of calcium lost from bones. It helps to prevent bone loss and to increase normal healthy bone formation in patients with osteoporosis.

Side effects• Swelling.• Warmth. • Pain or tenderness.• Redness.

DOSAGE

DRUGS DOSE Boniva (Ibandronate)

Cibacalcin (Calcitonin)

Evista (Raloxifene)

white, oblong, 2.5 mg film-coated tablet

100-200ul in nasal spray form, one puff per day

1 tablet (60 mg) orally once a day

Therapies:Physical therapy:

Help you build bone strength and improve your posture.

Balance and muscle strength.

OSTEO DIET Eat your veggies and fruit

Get some daily sunshine for vitamin D

REFERENCES Drugs.com Medicine.net Medscape education.comScience daily.com

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