Saturday, 21 November 2015

More information about how the bones work and the medications

Bone remodeling

In order to cure osteoporosis, we have to take a closer look to what our bone does. Bone is actually a living tissue that constantly generate new bones while replacing old bones. Bone remodeling is the process where bones are continuously generated to replace the old bones. It consist of 2 different stage, bone resorption and bone formation.

Bone resorption, is also known as the breakdown or removal of bone, requires special cells to occur. For example, osteoclasts which will appear on the bone’s surface and dissolve bone tissue and creates small cavities. While bone formation requires osteoblast to form new bone tissues. Normally, the rate of bone resorption and bone formation should be the same. In osteoporosis, the rate of bone resorption happens much more quickly than the rate of bone formation hence resulting in loss of bone mass.

Why is it that osteoporosis occur so much common in postmenopausal period in women?

This is because in woman, osteoclast activity will increase due to a decrease level in estrogen, this result in further net loss of bone mass hence causing more serious scenarios of osteoporosis.

Is it possible to use estrogen therapy to cure it since estrogen is a cause of osteoporosis?

Well, it is not totally impossible, but when estrogen is taken alone, it can cause an increase of risk for the woman to develop cancer at the uterine lining, or called endometrial cancer. One way to reduce this effect is too add in progesterone as well. There can also be side effects such as vaginal bleeding, breast tenderness and gallbladder disease.

Different types of medication

Basically we can sum up to 2 types of medication. One of it is antiresorptive medication. Aclasta, the drug that I mentioned in the previous post belongs to this group. They slow down the rate of bone loss. While the rate of bone loss is slowed down, this allow the body to have enough time to synthesize new bones to replace the old bones, hence may cause to the bone density to increase bits by bits.

Another type of drug is called the anabolic medication. One example would be the Teriparatide. It is a form of parathyroid hormone that can increase the rate of bone formation. By boosting the rate of bone formation, it will not cause the bone tissue to weaken, hence preventing osteoporosis.
Image result for teriparatide injection
What happens in the long time after taking the drugs?


Past studies of bisphosphonates such as Aclasta, suggests that after stopping the intake of such drugs, the effect of it may continue for several years as the drugs can remain in the bone for a long time.

References
http://www.medicinenet.com/script/main/art.asp?articlekey=11794
http://nof.org/articles/22
http://www.osteoporosistreatment.space/tag/aclasta
http://www.royalmedical.in/osteoporosis-drugs.html
https://www.youtube.com/watch?v=0dV1Bwe2v6c

Thursday, 19 November 2015

Information on Aclasta( Drug that cure Osteoprorosis)

Aclasta:
Consist of zoledronic acid which belongs to a drug class called the bisphosphonates. It inhibits the release of calcium from bones hence reducing the loss of bone mass. It is commonly used to treat Paget's disease of the bone and osteoporosis in men. It can also be used to treat and prevent osteoporosis in postmenopausal women as well as osteoporosis caused by steroid medications.
Zoledronic acid.svg
Chemical formula for Zoledronic acid

Route of administration:
Intravenous

DO NOT TAKE when:

  • Low blood calcium level
  • Pregnant or breastfeeding
  • Aspirin-sensitive asthma
  • A thyroid or parathyroid disorder
  • Malabsorption syndrome (an inability to absorb food and nutrients properly)
  • A history of surgical removal of part of your intestine
  • Bone cancer
  • Kidney disease


Aclasta’s effect to babies:

It is used as an effective method for birth control. Aclasta drug is able to pass into the breast milk of the mother and enter the baby body causing harm to the baby. The active ingredient, zoledronic acid is able to harm the baby, hence not safe to be taken when pregnant or breast feeding.

How the drug may look like:

Each bottle of the drug consist of zoledronic acid 5 mg/100 mL monohydrate 5.330 mg as well as nonmedicinal ingredients mannitol, sodium citrate, and water for injection.
  
Side effects:
  • bone, muscle, or joint pain
  • constipation
  • dizziness
  • excessive sweating
  • fever and chills
  • flu-like symptoms (e.g., fever, chills, bone pain, or muscle and joint pain)
  • headache
  • heartburn
  • nausea
  • reduced sense of touch
  • skin reaction at the injection site
  • tiredness
  • vomiting


References:
http://gazettereview.com/2015/08/five-natural-heartburn-remedies/
https://en.wikipedia.org/wiki/Zoledronic_acid
https://intermountainhealthcare.org/blogs/2013/10/don-t-struggle-with-vertigo-and-dizziness-get-treated/
http://emmamaitland-carew.co.uk/aches-pains/
https://workersbravo.wordpress.com/category/listicles/page/2/
http://my-definitions.com/fr/definition/IV
http://babytrendwatcher.nl/en/page/8/



More Information for Osteoporosis

Main causes
  • Bone did not grow adequately early in life, reaching below optimal peak bone mass
  • Rate of bone reabsorption higher than rate of bone mass formation
  • Hormonal change, decrease in estrogen level for female and decrease in testosterone levels for male

Symptoms
  • Fracture
  • Collapsed vertebrae - back pain, loss in height and curved back
  • Otherwise no symptoms as it is a silent disease

How does it affect individuals with the disease?
May cause spine fracture with little shock e.g. coughing
Leads to pain and deformity

Cures
Medication
  • Aclasta (intravenous drug)  
Avoid bone loss and maintain bone strength
  • Calcium - 1200 mg a day. Helps to build strong teeth and bones
  • Vitamin D - 2000 units a day. Helps to maintain blood levels of calcium and phosphorus. It helps body to absorb calcium to form strong teeth and bones.
  • Exercise - stretching and strengthening exercise to rebuild the weak skeletal frame and improve posture e.g. yoga, aerobic

Prevention

Start from young - promote awareness of good nutrition in young people to build up bone strength

References
http://blog.23andme.com/23andme-research/exercise-can-modify-dna-in-fat-cells/

Tuesday, 17 November 2015

Introduction to Osteoporosis

Introduction:
Osteoporosis is made up of 2 components which literally mean ‘porous bone’ – ‘osteo’ which stands for bones while ‘porosis’ is for bone. Osteoporosis is the weakening of bone tissues that causes it to become very brittle to the extent that a simple fall can cause a fracture.
People who are at risk:
It is a hormone-related disease that can affect everybody regardless of gender and age but it occur more commonly is postmenopausal women. Peak bone mass is achieved at the age of 30. Afterwards, the bone mass will slowly decrease. In pregnant and lactating women, the rate of bone loss will increase much faster if the increased calcium demands of being pregnant or breastfeeding are not met.

According to a research done by SingHealth, the risk of 200 million women worldwide suffer from osteoporosis and a woman’s risk of hip fracture is equal to the combined risk of developing breast, uterine and ovarian cancer. In Singapore, the cases of osteoporosis - related hip fractures in women over 50 years is 8 times more than that of breast cancer cases.
Pic on the left: healthy people, high bone density, less prone to facture
Pic on the right: People with osteoporosis, low bone density, more prone to fracture
http://scienceblogs.com/lifelines/2014/11/14/new-treatment-for-osteoporosis/
http://www.osteoporosistreatment.link/tag/osteoporosis-x-ray-vs-normal

References:
http://www.singhealth.com.sg/PatientCare/ConditionsAndTreatments/Pages/Osteoporosis.aspx
http://www.medicalnewstoday.com/articles/155646.php
http://www.mayoclinic.org/diseases-conditions/osteoporosis/basics/definition/con-20019924