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 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
 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.
 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.
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 abuse
hypercalciurea
 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 chronic
diseases such as rheumatoid arthritis or
liver diseases

 Hyperthyroidism
 Vitamin D deficiency
 Excessive alcohol consumption




   Diet low in calcium

 Malabsorption
 Fracture
 Swelling


 Joint pain


 Disfigurement


 Debilitation


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


 curtailing excessive alcohol intake


 exercising regularly


consuming a balanced diet with
adequate calcium and vitamin D.
 BIOPHOSPHONATES                 :
      GENERIC NAME         TRADE NAME

  • Alendronate       • Fosamax


  • Ibandronate
                      • Boniva


  • Zoledronic acid   • Reclast
 CALCITONIN:

        GENERIC NAME         TRADE NAME
    • Calcitonin        • Cibacalcin




 RALOXIFENE:
         GENERIC NAME         TRADE NAME

     • Raloxifene        • Evista
Biophosphonates:
   Alendronate (Fosamax)

Ibandronate (Boniva)


Zoledronic acid (Reclast)
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.
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)    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 and
improve your posture.

 Balance and muscle strength.
 Eat your veggies and fruit


 Get some daily sunshine for
vitamin D
REFERENCES
 Drugs.com
 Medicine.net
 Medscape education.com
Science daily.com
Osteoporosis

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Osteoporosis

  • 1.
  • 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.
  • 6.
  • 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
  • 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 .
  • 18.
  • 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