Bones provide structure, movement, and protection. Osteoporosis is a bone disorder where density decreases, weakening bones and increasing fracture risk, especially in the spine, hips, wrists. It is usually age-related but can be caused by other factors like medications, diseases, smoking. Diagnosis involves bone density tests and x-rays. Treatment focuses on lifestyle changes and medications like bisphosphonates, calcitonin, raloxifene which slow bone loss and increase density.

2.  Bones are rigid organs that form part of
the endoskeleton of vertebrates.
Functions:
 Movement
 Support
 Protect various organs of the body

3.  Production of blood cells
 Store minerals
Disorders of bone:
 Bone fracture
 Osteomyelitis
 Osteoarthritis
 Osteoporosis

4.  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.

5.  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.

7.  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.

8. Primary osteoporosis:
 The condition is caused by age-related
bone loss.
 Usually in people after the age of 70.

9. Secondary osteoporosis:
 The loss of bone mass is caused by
lifestyle factors, diseases or medications.
Causes:
 Hypogonadism
 alcohol abuse
hypercalciurea
 immobilization

10. • At the top is the
normal Bone
• Effected by
osteopenia showing
lack of calcium
• Severe case of
osteoporosis

11.  Thin and small body frame
 Family history of osteoporosis
 Smoking

12.  Low testosterone levels in men
(hypogonadism)
 Chemotherapy
 Chronic inflammation, due to chronic
diseases such as rheumatoid arthritis or
liver diseases
 Hyperthyroidism

13.  Vitamin D deficiency

14.  Excessive alcohol consumption
 Diet low in calcium
 Malabsorption

15.  Fracture

16.  Swelling
 Joint pain
 Disfigurement
 Debilitation
 Kyphosis (is a common condition of a
curvature of the upper back.)

17.  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 .

19.  Lifestyle changes
 curtailing excessive alcohol intake
 exercising regularly
consuming a balanced diet with
adequate calcium and vitamin D.

20.  BIOPHOSPHONATES :
GENERIC NAME TRADE NAME
• Alendronate • Fosamax
• Ibandronate
• Boniva
• Zoledronic acid • Reclast

21.  CALCITONIN:
GENERIC NAME TRADE NAME
• Calcitonin • Cibacalcin
 RALOXIFENE:
GENERIC NAME TRADE NAME
• Raloxifene • Evista

22. Biophosphonates:
 Alendronate (Fosamax)
Ibandronate (Boniva)
Zoledronic acid (Reclast)

23. 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 to
pyrophosphate. A bisphosphonate group mimics
pyrophosphate's structure, thereby inhibiting
activation of enzymes that utilize
pyrophosphate.

24. 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.

25. Side effects:
 Heartburn, abdominal pain, and irritation
of the esophagus.
Headache and pain in muscles and joints.

26. 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.

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

28. 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.

29. 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

30. Physical therapy:
 Help you build bone strength and
improve your posture.
 Balance and muscle strength.

31.  Eat your veggies and fruit
 Get some daily sunshine for
vitamin D

32. REFERENCES
 Drugs.com
 Medicine.net
 Medscape education.com
Science daily.com