OSTEOPOROSIS.-a skeletal disorder

What is osteoporosis?

Osteoporosis is a bone disease in which a bone loses its density and may break in a just a minor accident. And the main sites for osteoporosis are spine, wrist and hips. But, they may effect other

bones such as arm or pelvis. Weak bones= osteopenia

Normal and osteoposis affectes bones:

A picture depicting osteoporosis

ETIOLOGY ( cause):-

It develops when there is a difference between bone tissue production and absorption.

Drop in the hormone levels of estrogen.Medications such as corticosteroids.Lack of exercise and lack of body

calcium.Excessive exercise in women may lead

to drop of estrogen hormone.Family history.

CLASSIFICATION:-

2 types:-(a)Primary osteoporosis-1: seen in post

menopausal women.Primary osteoporosis-2: it is senile,

seen in older people.(b) Secondary osteoporosis:- can effect

young and middle aged people.

SIGNS AND SYMPTOMS:-

1.If a person has a fracture just for a small slip or fall.

2.If a person is naturally thin or small framed.

3.If a is having corticosteroids for an autoimmune disorder from a long period of time.

4. SMOKING , has a high relation with osteoporosis.

5.If a person takes more than 2 alcoholic drinks per day.

6.If a person is lactose intolerant and for some other reasons they are not drinking milk.

7.If a person has an eating disorder.Eg: anorexia.

8.Women , when their periods are irregular which is due to disturbed estrogen levels.

9.If a person has a family relative who has osteoporosis before the age of 50.

10.If a person is Asian or Caucasian .That person is more prone to osteop orosis.

Test to be conducted:

DEXA scan( Dual energy X- ray absorbimetry).

Qualitative computed tomography. Blood test markers.( using radio

isotopes). Bone densitometry AKA bone

density test. Ultrasound scanning. MRI( magnetic resonance imaging). X-Ray scan.

THERAPY1.DRUG THERAPY:Drugs which are given for

osteoporosis:1st line drugs: alendronate,

resendronate,denosumab,etc.2nd line drugs: Ibandronate, raloxifene3rd line drugs: calcitonin.If other medications have not worked:

teriparatide.

CHOICE OF DRUG:

Biphosphates are the most common drugs used in osteoporosis. But, they

have side effects like irritation of gut.

Conclusion: So it shouldn't be given to patients suffering with bowel irriation and kidney disorders.

Raloxifene is a substitute to biphosphates and is given to women.

Strontium ranelate acts on the cells that build the bone and cells that destroy the bone.

Parathyroid hormone treatment is given spinal fractures. It works by building new bones.

Denosumab works and blocks the osteoclasts that break the bones.

Calcium and vitamin D are given in combination therapy.

Calcitonin acts a synthetic hormone and acts by strengthening the skeleton.

GOALS OF TREATMENT:

PRIMARY GOAL: Control of pain in case of fracture.

SECONDARY GOAL: If it is a secondary goal treatment of primary cause should be given.

MANAGEMENT OF OSTEOPOROSIS Reduction of incidents of fractures. Reduction of pain at the fractured area. Therapies which reduce the fracture

occurrence. Risk factor on fracture and their

management.MANAGEMENT IN ELDERLY: Biphosphates and raloxifene are

generallyused.

MANGEMENT IN PREGNANCY: occurs in 3rd trimester . Usually severe back pain occurs.

NON DRUG THERAPY:

Taking of calcium rich foods. If your on corticosteroid treatment

check your bone density and be under medical supervision.

Smoking and alcohol cessation. Check out for any hormone related

problems. Daily exercise.

THANK YOU