Osteoporosis is a disorder of bone remodeling resulting in weak, fragile and porous bones particularly observed in postmenopausal women and with progression of age. Many of the drug categories like biphosphonates, SERM, vitamin D preparations, biologicals, parathyroid hormone analogues, calcitonin and calcium supplements are indicated for osteoporosis. Biphosphonates are widely prescribed drugs that mainly show antiresorptive activity. These drugs should be taken in upright position as they may cause esophageal reflux and ulcers. Caclitonin is one of the drug that is used to control pain in the osteoporosis and it is given intranasally.
Eight types of drugs used in osteoporosis what is osteoporosis osteoporosis is caused by an imbalance in the bone remodeling so this results in the reduced bone formation and increased bone resorption which results in the decreased bone strength in the patients in the patients as the bone strength is decreased we can observe a weakening of the bones and brittle bones
Which are easily fragile and broken and a pain in the bones is also observed in the patients with the osteoporosis what are the causes for osteoporosis osteoporosis is actually observed both in the men as well as women but particularly it is more observed in the women because of the hormonal effects as well as the loss of this calcium from the bones particularly
It is more observed in the postmenopausal woman so in the postmenopausal woman there is a lack of estrogen synthesis which results in the decreased bone strength and demineralization of the bones which lists the osteoporosis and osteoporosis can also be observed with the progression of the age both in the men as well as women as is progress there is a gradual
Loss of the bone mass because of the demineralization as well as the increased osteoclast activity and sometimes if you have the drugs which are used for a long term can produce the osteoporosis particularly these osteoporosis can be observed with the drugs like glucocorticoids like the prettiness loam ystos and antagonists like the tamoxifen which are used for
The treatment of the breast cancer and if you have the antacids particularly there and acids which are used for the grd gastroesophageal reflux disorder and even proton pump inhibitors can also produce on a long term a weakening of the bones and heparin heparin is one of an iv anticoagulant when it is given for a longer period you can produce a osteoporosis so
Still this list can be increased so so many drugs may increase the risk of the osteoporosis how the drugs are acting in the osteoporosis so bone remodeling in was a too important process one is osteoclast and second is the osteoblast osteoclast is the bone resorption whereas the osteoblasts osteoblasts is the bone formation so now the target in this osteoporosis
Treatment of osteoporosis is that we have to inhibit this osteoclast formation and we had to increase the osteoblasts so the drugs mainly act by inhibition of the osteoclast formation or increase the osteoclast apoptosis and some of the rugs are also going to increase the osteoblasts formation which promotes the bone formation and they suppress the osteoblasts
Apoptosis so that the balance is going to be restored thereby the bone loss can be prevented so now in this video let us see what are the different types of drugs that can be used in the treatment of osteoporosis and how they can affect a that osteoclast osteoblasts arm so the first one is the by phosphonates by first when it’s having the structure like this
And we can observe the two phosphates groups here so these phosphate groups are acting like the inorganic phosphates and thereby they’re going to interact with the bone resorption here two phosphate groups are attached with a carbon and this carbon is attached with the alkyl groups these alkyl groups may have either nitrogen or they may not have the nitrogen and
Based on that by phosphonates are going to be classified so we have the by phosphonates are ending with the grenade like the 80 donate and lnternet these are the by phosphonates now these by phosphonates can be classified based on the alkyl group whether having a nitrogen or not having the nitrogen so some of these are classified as non nitrogen’s which are the
First generation by phosphonates and second is the alkyl amino by phosphonates which are the second generation by foreign aids and third one is the heterocyclic by phosphonates so first one it it donate and tile you donate are the two non nitrogen containing by phosphonates which are the first generation by phosphonates similarly pamidronate alendronate and iban
Donate or the by phosphates having an alkyl amino sidechain and finally receipt donate and jolie donate or the by phosphonates hang the heterocyclic nitrogen and now this the last category is the third generation by phosphonates and among these drugs iban donate is one of the drug which is given for every three months and it is a one of a long-acting by phosphate
Similarly john internet is still more long-acting and it is given once in here in order to treat the osteoporosis in all these by phosphonates are having one of the common side effect like the ease of angle ulcers so when these drugs are given the patient has to be in the upright position you are not to prevent the reflex of the drug into the ease of agus and food
Also decreases the absorption of the by phosphate so these drugs should be given 30 minutes before the food intake and ii was a relics afine ran oxygen is a sc rm that is a select two is rosin receptor modulator yes erm is a term that is given for a drugs which are acting like both oconus as well as and ammonius so raloxifene is acting like a partial agonist that
Means it also produced the the agonist action of the estrogen as well as it also and on as fear of the actions of the east ocean particularly it is going to decrease the osteoporosis by increasing the agonist activity of the east rajan’s so it increases the osteoblast that is a bone formation and it also decreases the osteoclast the bone resorption in this way
Raloxifene can show a partial agonist activity by stimulating the east raja’na carry on the bones thereby it increases the the bone formation and decrease a bone resorption and aleksef in can show some of the hot flashes and vaginal bleeding as you have the side effects because it is an east rosen receptor modulator third type of drug is a teriparatide so it
Is a parathyroid hormone analog and we can observe in this name the pa or ea t which is a parathyroid hormone analog so this teriparatide is a parathyroid hormone analog which is actually responsible for the osteoblast activity there but increase the bone our mission but teriparatide is having no anti receptive activity so it’s mainly act by promoting the bone
Formation and fourth type is the biologicals so one of the truck is the dino zoom am here map indicates a monoclonal antibody osteoclast promoter cells are having one of the receptor to this receptor one of the ligand is going to bind that is the rank ligand once this rank ligand is bind to these receptors now these receptors are undergoing the modification so that
Their current a multinucleated osteoclast cells now this multinucleate osteoclast cells are respond for the bone resorption so in this way rank ligand promotes the bone resorption by binding to the osteoclast progenitor cells now dino su map is going to antagonize the binding of this rank ligand to these receptor thereby t inhibits the conversion of the osteoclast
Progenitor cells to the multinucleated osteoclast cells in this way dino so map is going to inhibit the bone resorption v one is the calcitonin cal stone is a peptide which is hangar 32 amino acids and this is actually secreted from the thyroid follicles and this drug can also be given externally so that it is going to be control the osteoporosis the main action of
This calcitonin is going to decrease the bone resorption and it also decreases a chasm as well as phosphate reabsorption in the renal tubules in this way the main action of the calcitonin is to control the kachin levels within the plasma and calcitonin is one of the drug which is given a necessary intranasally and it mainly relieves the pain in the austria porosus
Even it is less effective than the by phosphonates this is the one of the drag which relieves the pain in the patients with the osteoporosis six what is the vitamin d so we have the drugs like ergo calcified all alpha cassaday all and calcitriol all these are the vitamin d preparations so this is mainly responsible for the increase rakeem intestinal absorption as
Well as decrease the chasm excretion so that’s why vitamin d is important for the bone growth and bone formation thereby to also decrease the osteoporosis and finally we have you have the other preparations which are also used in the osteoporosis so first one is the strontium strontium is having a dual effect it is going to increase the bone formation as well as it
Is going to decrease the bone resorption similarly an the drug is the calcium gluconate actually calcium gluconate is indicated for the hyperkalemia but as calcium gluconate acts as the source of the calcium so it is also used for the conditions where there is a low blood calcium is present it can act as an calcium supplement in the treatment of the osteoporosis
The main target in the osteoporosis is to increase the osteoblast formation and decrease the osteoclast activity many of the drugs are going to act on the osteoclast thereby they’re going to show the aunt iris operative activity and fear the drugs are going to promote the osteoblast activity thereby increase the bone formation the main category of drugs here are
The by phosphonates which are well prescribed and among these i bandra nate and joel internet are the long-acting drugs which are given for three months and one year respectively and by phosphonates may show isa fagin ulcer so they should be taken with the upright portion out to prevent the use of vehicle reflux and the absorption of these drugs is also inhibited
By foods so they should be taken 30 minutes before the fall and catch stone is one of the track which is going to relieve the bone pain in the ostia porosus relics if he needs the sc rm which is hanging the easter rosa nick activity on the bone thereby prevents the osteoporosis and other preparations like the vitamin d and parathyroid hormone can also suppress the
Osteoporosis and calcium gluconate can be given as a calcium supplement and strontium caning promote the bone formation as well as decrease the bone resorption their weight can prevent the osteoporosis so in this way we have the different types of drugs which are used in the treatment of osteoporosis
Transcribed from video
8 types of drugs used in Osteoporosis By egpat
