OSTEOPOROSIS

OSTEOPOROSIS Is a systemic skeletal disease

characterised by,
 Low bone density
 micro-architecture detoriation of bone tissue
 which enhances bone fragility
 and Increases the risk of fracture
 EPIDEMIOLOGY:

 1 in 3 women over 50 years suffer from

osteoporosis
 1 in 5 men over 50 years suffer from osteoporosis
 15-30% of men & 30-50% of women suffer from
fractures related to osteoporosis in their lifetime
 western-70 to 80 years
India-50 to 60 years
Categorized in to,
 primary osteoporosis-postmenopausal[type-1]
Senile[type-2]
 secondary osteoporosis-due to disease conditions

RISK FACTORS :
 PATHOPHYSIOLOGY :
 PEAK BONE MASS
 BONE REMODELLING
Peak bone mass the amount of bone tissue in the
skeleton,known as bone mass,can keep growing
until the late 20’s. At that point,bones have
reached maximum strength and density.
After peak bone mass is attained,both men
&women lose bone mass over the remainder of
their lifetime
BONE MODELLING-During growth skeleton increases
in size by apposition of new bone tissue on outer
surface of cortex.
BONE REMODELLING-Cellular process of bone activity
by which both cortical & cancellous bone are
maintained.
 OSTEOPOROSIS Results from bone loss due to age
related changes in bone remodelling as well as
some extrinsic & intrinsic factors.
CLINICAL MANIFESTATIONS :
Osteoporosis has been usually called as “silent
disease”because bone mass is lost over many years with
no signs &symptoms.
 Loss of height
 Back pain
 Vertebral collapse etc
 DIAGNOSIS :
 X-RAY STUDIES :Determine bone density
 Radiographics : Bone mass[osteopenia]
 Ultrasonography: Determine bone density
 Dual energy X-ray absorptimetry[DEXA]
measures bone mineral density.
 MANAGEMENT :

LIFE STYLE MODIFICATIONS :

Physical activity-weight bearing & muscle strenthing
exercises.
 Exercise improves bone strength by 30 to 50%
 Cessation of alcohol,smoking,high caffeine intake
 Adequate sunexposure
 DRUG THERAPY :
 calcium should be taken in certain adequate
amounts.
 VIT D-800 to 1000 International units[IU] of vitamin
d per day for adults age 50 & older.
BIOPHOSPHONATES :
 These are analogues of pyrophosphates
 promotes apoptosis of osteoclasts
Eg:Alendronate -10mg daily tablet
Ibandronate-3mg every 3 months through Iv route
Residronate- 5mg daily tablet
SIDE EFFECTS:For oral biphosphonates are,
 Gastro intestinal problems [difficulty in swallowing]
 All biophosphonates are contraindicated in patients
with GFR below 30- 35ml/min.
CALCITONIN-a synthetic throid hormone usually
prescribed as nasal spray which, reduces loss of calcium
level & increases reabsorption of calcium in GIT
HORMONE REPLACEMENT THERAPY:
Estrogen with or without progestin is used.
 Dose-0.625mg daily
 Route-oral or transdermal
SIDE EFFECTS:Increased incidence of coronary heart
diseases etc.
TERIPARATIDE[PTH]:used in treatment of osteoporosis
who are at high risk for fracture.
 Dose-20 micrograms daily subcutaneously
SIDE EFFECTS:Leg cramps,dizziness,nausea
THANK
YOU !!