The lectures in points : - 1- Osteoporosis. 2- Paget's disease. 3- Drugs used in osteoporosis and paget's disease treatment. 4- Practical notes. 5- Rapid review. 6- Test yourself.

1. Pharmacist Development Group Scientific Department Present

2. Drugs used in osteoporosis and paget’s disease treatment By Dr.MohamedAbdel Rahman

3. The Lecture In Points

4. Osteoporosis Visit video department on pharmacist development website

10. and may also cause pressure on nerves and result in bone pain and neurological complications.

12. Drugs used for oseoporosis and paget’sdisease treatment 1- Bisphosphonates. 2- Calcitonin. 3- Hormone replacement therapy. 4- Selective oestrogen receptor modulators. 5- Teriparatide. 6- Other drugs.

14. Bisphosphonates are preferred for prevention and treatment of postmenopausalosteoporosis and used also for paget’s disease.

15. Bisphosphonates that are given orally: Alendronate, Risedronate, ClodronateandEtidronate. They are given once daily or once weekly.

19. It is given daily by sub-cutaneous injections and can be taken intramuscular or intranasal (spray).

21. Common adverse effects of intranasal formulation include rhinitis and other nasal symptoms.

23. Raloxifene (evista, ralogen, ralox, sedovesta) mimic the inhibitory effects of oestrogen on osteoclasts. It increase the bone density without increasing the risk of endometrial cancer. In addition, it reduce the risk of invasive breast cancer.

24. Raloxifene is the first line alternative for postmenopausalosteoporosis in women who are intolerant to bisphosphonates.

26. Teriparatide (forteopen) is given subcutaneouslyonce daily. It is effective in the treatment of glucocorticoid-induced osteoporosis.

28. Enbucrilate (histoacryl) is a new drug to treat osteoporosis . It increases bone formation.

31. Because Bisphosphonatescause hypocalcaemia, patients should take 1000 mg elemental calcium and 800 IU of vitamin Ddaily.

32. Calcium salt supplements can be addedtocalcitonin therapy if the diet is low in calcium or if the patient is very old.Lipid lowering agents : rapid review

34. Patient who take Oral Bisphosphonates must be upright for at least 30 minute after administration to decreaseesophageal ulcers.

35. Oral Bisphosphonates should be taken with plenty of water.

36. Intravenous bisphosphonates must be taken in slow IV infusion.secretion of thyroxin hormone : video

37. Rapid review

39. In Paget’s disease, osteoclasts become hyperactive and osteoblasts are unable to replace bone at the same rate. Instead affected bones develop fibrous tissue and become enlarged.

40. Bisphosphonates (reduce bone resorption) are preferred for prevention and treatment of postmenopausal osteoporosis and used also for paget’s disease.Understanding of allergy : video

42. Intravenous Bisphosphonates(Pamidronate, Clodronate, Zoledronate) are used mainly for hypercalcemia.

43. Calcitonin (miacalcic, bonin) (reduce bone resorption) is the preferred treatment in severe Paget’s disease and used also for oseoporosis. it is given daily by subcutaneousinjections and can be taken intramuscular or intranasal (spray).seasonal allergic rhinitis : note

45. Selective estrogen receptor modulators e.g. Raloxifene (evista,ralogen, ralox, sedovesta) mimic the inhibitory effects of oestrogen on osteoclasts. used for prevention and treatment of osteoporosis.

46. Teriparatidestimulates the activity of osteoblasts. Is recommended for use in women over 65 with low bone mineral density and a history of fractures.

47. Teriparatide (forteopen) is givinsubcuteneouslyoncedaily. It is effective in the treatment of glucocorticoid-induced osteoporosis.Gallstones : rapid review

48. Test yourself Pharmacist Development Enjoy learning www.pharmacist-development.com

56. Pharmacology for the Health Care. Professions.

57. Atlas 2 .