Download Osteoporosis

OSTEOPOROSIS
IACOVOS ANTONIOU
GROUP 35 (2010)
Osteoporosis
“A systemic skeletal disease characterized by low bone
mass and microarchitectural deterioration, with a consequent
increase in bone fragility with susceptibility to fracture.”*
One in 2 women and One in 8 men over 50 will have an
osteoporosis related fracture.
The estimated cost for osteoporotic and associated
fractures is 38 million a day!
Risks for Osteoporosis
In young women
• Low calcium intake
• Low body weight
• Limited exercise
• Hypoestrogenism
In others
• Menopausal/postmenopausal
status—without HRT
• Cigarette smoking
• Low-trauma fractures
• Hyperparathyroidism
• Chronic corticosteroid use
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Normal bone
Osteoporosis
Bone Health
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Bones are living tissue, they provide
structural support, protect vital organs and
store calcium.
Until age 30, we store and build bone
effectively.
As part of the aging process, bones begin to
break down faster than they are formed.
Accelerates after menopause. Estrogens are
the hormones that protects against bone loss.
Prevention
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Building strong bones in childhood and
adolescence is the best defense.
A balanced diet rich in calcium and Vitamin D
Weight bearing exercise
A healthy lifestyle with no smoking or
excessive alcohol intake.
Bone density testing and medication when
appropriate.
Calcium
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Is needed for heart muscles, and
nerves to function properly.
Inadequate amounts contribute to
osteoporosis.
Appropriate calcium intake falls
between 1000 and 1300 mg a day.
Calcium
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Increase calcium:
Consume calcium rich foods such as,
low-fat milk, cheese, broccoli, and
others.
Calcium supplement, if dietary calcium
consumption is inadequate
How to get enough Calcium
every day!
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Follow the Food Guide Pyramid
for Dietary Calcium Sources
Dairy – low fat yogurt, skim milk, cheese, chocolate
pudding, ice milk, ice cream or frozen yogurt.
Protein – tofu, sardines, salmon
Vegetables – turnip greens, Bok Choy, Broccoli,
collard greens
Other foods: vegetable lasagna, cheese enchilada,
cheese pizza, calcium fortified orange juice.
Vitamin D
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Is needed for your body to absorb
calcium.
Comes from 2 sources: the sun and
Fortified dairy products, egg yolks,
saltwater fish, and liver.
Need 400–800 IU a day.
Vitamin D
Medications
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There is no cure, but several medications
have been approved.
Each stops or slows bone loss, increases bone
density, and reduces fracture risk.
Estrogen Replacement,
Alendronate, raloxifene and risedronate are
prescribed to prevent and treat the disease.
Bone-Building Checklist
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Maintain a calcium rich diet.
Get plenty of vitamin D
Engage in weight-bearing exercise
Don’t smoke and limit alcohol intake
Consider Hormone Replacement or
other medications if you are at risk.
Estrogens
Estrogens include the natural hormones as well
as semi-synthetic and synthetic (stilbene) agents
Estrogens are used as hormone-replacement
therapy (menopause), in oncology and as
contraceptives
Most estrogen in the female is produced in the
ovaries by the theca interna and the granulosa cells of
the follicles
Actions of estrogens
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on sexual organs (primary and secondary
sexual characteristics)
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ovaries : stimulate follicular growth; small doses cause
an increase in weight of ovary; large doses cause
atrophy
uterus: endometrial growth
vagina: cornification of epithelial cells with thickening
and stratification of epithelium
cervix: increase of cervical mucous with a lowered
viscosity (favoring sperm access)
Actions of estrogens
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Development and maintenance of internal
(fallopian tubes, uterus, vagina), and external
genitalia
skin: increase in vascularization, development of
soft, textured and smooth skin
bone: increase osteoblastic activity
electrolytes: retention of Na+, Cl- and water by
the kidney
cholesterol: hypocholesterolemic effect
Natural estrogens
Conjugated estrogenic substances:
an amorphous preparation containing water
soluble conjugated forms of mixed estrogens
from the urine of pregnant mares (Premarin,
Cenestin - synthetic conjugated estrogens)
estradiol :
oral : Estrace
transdermal: Climara, Alora, Vivelle, Vivelle-Dot,
Estraderm, FemPatch
Natural estrogens
estrone:
Kestrone 5 (injectable only)
esterified estrogen
(75–85% sodium estrone sulfate and 6–15% sodium
equilin sulfate)
Estratab; Menest
estropipate (piperazine estrone sulfate)
Ogen; Ortho-Est
Natural estrogens
Sustained-release injectables:
estradiol valerate in oil (Delestrogen; Valergen)
estradiol cypionate in oil (depGynogen;
DepoGen)
duration of action from 3 to 8 weeks
esterified at C-17 hydroyl group