Bones are rigid organs that form part ofthe endoskeleton of vertebrates.Functions: Movement Support Protect various organs of the body
Production of blood cells Store mineralsDisorders of bone: Bone fracture Osteomyelitis Osteoarthritis Osteoporosis
Osteoporosis is a conditioncharacterized by a decrease in the densityof bone, decreasing its strength andresulting in fragile bones. It leads to abnormally porous bone thatis compressible, like a sponge. Normal bone is composed of protein,collagen, and calcium, all of which givebone its strength.
This disorder of the skeleton weakens thebone and results in the frequent fractures inthe bone. The spine, hips, ribs, and wrists are commonareas of bone fractures from osteoporosis.
Fractures - over 1.5 million annually caused byosteoporosis in the USA. Vertebrae fracture - approximately 700,000vertebral (spinal) fractures annually in the USA. Hip fracture - about 300,000 hip fracturesdue to osteoporosis annually in the USA. Wrist fracture - about 250,000 wristfractures in the USA.
Primary osteoporosis: The condition is caused by age-relatedbone loss. Usually in people after the age of 70.
Secondary osteoporosis: The loss of bone mass is caused bylifestyle 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
Thin and small body frame Family history of osteoporosis Smoking
Low testosterone levels in men(hypogonadism) Chemotherapy Chronic inflammation, due to chronicdiseases such as rheumatoid arthritis orliver diseases Hyperthyroidism
Swelling Joint pain Disfigurement Debilitation Kyphosis (is a common condition of acurvature of the upper back.)
A routine X-ray can reveal osteoporosis of thebone because the bones appear much thinner andlighter than normal bones. Bone mineral density test that can measure thestrength of your bone. Often blood tests are used to measurecalcium, phosphorus, vitamin D, testosterone, andthyroid and kidney function. Ultrasound .
Lifestyle changes curtailing excessive alcohol intake exercising regularlyconsuming a balanced diet withadequate calcium and vitamin D.
MODE OF ACTION This 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 topyrophosphate. A bisphosphonate group mimicspyrophosphates structure, thereby inhibiting activation of enzymes that utilize pyrophosphate.
PHARMACOKINETICSOf 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 irritationof the esophagus.Headache and pain in muscles and joints.
Calcitonin Cibacalcin MODE OF ACTIONIt 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 ofcalcium lost from bones. It helps to preventbone loss and to increase normal healthy boneformation in patients with osteoporosis. Side effects• Swelling.• Warmth.• Pain or tenderness.• Redness.
DOSAGE DRUGS DOSE Boniva (Ibandronate) white, oblong, 2.5 mg film-coated tablet Cibacalcin 100-200ul in nasal(Calcitonin) spray form, one puff per day 1 tablet (60 mg)Evista (Raloxifene) orally once a day
Physical therapy: Help you build bone strength andimprove your posture. Balance and muscle strength.
Eat your veggies and fruit Get some daily sunshine forvitamin D