1 / 18

Drugs for osteoporosis (download the lecture from skilltest.co )

Drugs for osteoporosis (download the lecture from www.skilltest.co.in ). Dr. Sarvesh Singh Associate Professor Dept. of Pharmacology KGMU, Lucknow E-mail-drsarveshsingh@gmail.com. PLASMA CALCIUM LEVEL. Regulated by 3 hormones: P arathormone (PTH ) Calcitonin

nknight
Télécharger la présentation

Drugs for osteoporosis (download the lecture from skilltest.co )

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Drugs for osteoporosis(download the lecture from www.skilltest.co.in) Dr. Sarvesh Singh Associate Professor Dept. of Pharmacology KGMU, Lucknow E-mail-drsarveshsingh@gmail.com d

  2. PLASMA CALCIUM LEVEL Regulatedby 3 hormones: • Parathormone(PTH) • Calcitonin • Calcitriol(active form of vit D) d

  3. PARATHORMONE (PTH) Stimulus for secretion of PTH: • Fall in plasma Ca2+ • Calcium-sensing receptors (CaSR) present on the surface of parathyroid cells. d

  4. d

  5. ACTIONS OF PTH PTH increases plasma calcium levels by: • Bone: • Bone resorption: increases 2. Kidney: • Calcium reabsorption in the distal tubule: increases 3. Intestines: • Calcium absorption increases indirectly • Enhance the formation of calcitriol(active form of vitD) • Calcitriol promotes intestinal absorption of calcium d

  6. MECHANISM OF ACTION OF PTH Mainly on bone: • Bone resorption: • Activation of osteoclast: Expression of PTH receptors: • PTH receptor is a G protein coupled receptor • Expressed on osteoblasts • Absent on osteoclasts d

  7. PTH ACTION ON OSTEOBLAST • PTH receptor located on osteoblast membrane • PTHinduces a factor 'Receptor for activation of nuclear factor-KB-ligand' (RANKL) • RANKL diffuses and combines with RANK on osteoclastprecursors PRECURSORS TRANSFORM INTO OSTEOCLASTS d

  8. d

  9. TERIPARATIDE • RECOMBINANT HUMAN PARATHYROID HORMONE • Approved for the treatment of: • Severe osteoporosis • PTH at high concentration: • Bone resorption predominates • PTH at low concentration with intermittent exposure: • Bone formation predominates • Only agent which stimulates bone formation • Equally or more effective than estrogens and BPNs: • In reducing risk of vertebral as well as non-vertebral fractures d

  10. TERIPARATIDE • Injected s.c. once daily • Given once daily produces intermittent action LIMITATIONS: • High cost • Need for daily s.c.injection d

  11. Drugs for Osteoporosis • Calcium and Vitamin D3 • Bisphosphonates • HRT • Raloxifene-selective oestrogen receptor modulator (SERM) which selectively binds to oestrogen receptors on bone. • Teriparatide- a fragment of recombinant human parathyroid hormone • Calcitonin- Given as a nasal spray of synthetic calcitonin d

  12. Bisphosphonates d

  13. Bisphosphonates • First line treatment for primary and secondary prevention of osteoporotic fractures • Reduce bone resorptionby inhibiting action of osteoclasts • Accelerate apoptosis of osteoclasts • Disruption of cytoskeleton and ruffled border • Most effective antiresorptive drugs • Available orally as daily or weekly tablet, or as a yearly injection • Daily and weekly- alendronate, risedronate • Yearly IV- zoledronate infusion d

  14. Side Effect • Oesophageal irritation/ ulceration if insufficient water taken with tablet or lie down after taking d

  15. Download the lecture from www.skilltest.co.in d

  16. d

  17. d

  18. Thank you d

More Related