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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.”*

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OSTEOPOROSIS

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  1. OSTEOPOROSIS IACOVOS ANTONIOU GROUP 35(2010)

  2. 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!

  3. Risks for Osteoporosis In others In young women • Menopausal/postmenopausalstatus—without HRT • Cigarette smoking • Low-trauma fractures • Hyperparathyroidism • Chronic corticosteroid use • Low calcium intake • Low body weight • Limited exercise • Hypoestrogenism

  4. Normal bone Osteoporosis

  5. Bone Health • 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.

  6. Prevention • 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.

  7. Calcium • 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.

  8. Calcium Increase calcium: • Consume calcium rich foods such as, low-fat milk, cheese, broccoli, and others. • Calcium supplement, if dietary calcium consumption is inadequate

  9. How to get enough Calcium every day! 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.

  10. Vitamin D • 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.

  11. Vitamin D

  12. Medications • 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.

  13. Bone-Building Checklist • 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.

  14. 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

  15. Actions of estrogens • on sexual organs (primary and secondary sexual characteristics) • 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)

  16. Actions of estrogens • 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

  17. 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

  18. 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

  19. 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

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