骨质疏松用药课件

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,Chapter,Drugs used for the treatment of osteoporosis,Department of pharmacology,Liming zhou,2015.9,Chapter,Contents,Osteoporosis,Antiresorptive drugs,Bone-forming drugs,Mineralization drugs,Contents Osteoporosis,Osteoporosis,Osteoporosis is a disease characterized by,low bone mass,(bone thinning) that leads to fragile bones and an increased risk of fractures of the hip, spine, and wrist.,Normal,Osteoporosis,Severe osteoporosis,Osteoporosis Osteoporosis is a,Osteoporosis,symptoms,Common symptoms :,Back pain,Stooped posture,Fractures,Osteoporosis symptomsCommon s,骨质疏松用药课件,Osteoporosis,types,Primary osteoporosis,Secondary osteoporosis,Idiopathic osteoporosis,Postmenopausal osteoporosis,Senile osteoporosis,OsteoporosistypesPrimary ost,Osteoporosis,risk factors,Factors you cannot change,Gender Age; Body size ;Ethnicity; Family history,Factors you can change,Sex hormones ; Anorexia nervosa;(,神经性厌食症,),Calcium and vitamin D intake; Medication use; Lifestyle; Cigarette smoking; Alcohol intake,Osteoporosisrisk factorsFac,Osteoporosis,diagnosis,The Bone Mineral Density Test (BDT),Detect low bone density before a fracture occurs,Confirm an osteoporosisdiagnosis if you already have one or more fractures,Predict your chances of having fractures in the future,Determine your rate of bone loss and monitor the effects of treatment,Osteoporosisdiagnosis The Bo,Osteoporosis,diagnosis,Bone Mass Density,The National Osteoporosis Foundation Recommends a BDT if: You use medications that cause osteoporosis,You have type I diabetes ,liver disease, kidney disease or a family history,You experience early menopause,You are postmenopause over 50 and have at least one risk factor,You are postmenopause over 65 and never had a test,OsteoporosisdiagnosisBone Mas,Osteoporosis,treatment,Comprehensive treatment forosteoporosis deals with:,Proper nutrition,Exercise,Safety issues to prevent falls,Medications,OsteoporosistreatmentComprehe,Osteoporosis,medications,Antiresorptive drugs:,Bisphosphonates, calcitonin, estrogen,Bone-forming drugs:,Parathyroid hormone, androgen,Mineralization drugs:,Calcium and vitamin D,OsteoporosismedicationsAntire,Bisphosphonates(,双磷酸盐,）,Pharmacological,Slow bone loss,Increase bone density,Reduce the risk fractures,Antiresorptive drugs,Slow bone lossAntiresorptive d,Bisphosphonate,clinical application,Osteoporosis in men and postmenopausal women,Preventing and treating osteoporosis due to glucocorticoid steroid medications,Treating high bloodcalciumlevels due to cancer,Treatingmultiple myelomaor solid tumor cancers that have spread to the bone,Bisphosphonateclinical applic,Bisphosphonateside effects,Nausea ,abdominal pain and indigestion,Rash and itchy skin,A temporary increase in parathyroid hormoneand serum transaminase,（血转氨酶）,Bisphosphonateside effects Na,Calcitonin,Calcitonin analogues (which are manufactured versions of calcitonin) can be useful for treating osteoporosis by slowing the breakdown of bone.,Calcitonin is a delicate molecule that would be destroyed by the digestive tract, it must be taken by nasal spray or by injection,With side effects of nausea , vomiting and allergicrash et al.,CalcitoninCalcitonin analogue,Estrogen Therapy,application,Estrogen therapy (ET) reduce bone loss, increase,bone density,in both the spine and hip, and reduce the risk of hip and spine fractures in postmenopausal women.,ET is,approved for preventing postmenopausal osteoporosisand are most commonly administered in the form of a tablet or skin patch,（经皮吸收）,.,Estrogen Therapyapplication,Estrogen Therapy,side effects,Taking estrogen alone increases a womans risk of developing cancer of the uterine lining (,endometrial cancer,).,To reduce this risk, women who still have a uterus (who have not had a hysterectomy,（子宫切除）,) should usually take a,progestin,in combination with estrogen,Estrogen Therapyside effects,Selective estrogen receptor modulators,(SERMS),are drugs that act like estrogen at some receptors,It acts like estrogen for preventing bone loss and improving cholesterol.,Currently, only,raloxifene,（雷洛昔芬）,that is approved to prevent and treat osteoporosis .,Selective Estrogen Receptor Modulators,Selective estrogen receptor mo,Bone-forming drugs,Parathyroid hormone(PTH)mechanism,With both catabolic and anabolic actions,Low dose,: PTH stimulate bone turnover and is associated with bone formation,（成骨作用）,High dose,: PTH increase the rate of bone resorption followed by slower rate of bone formation,（破骨作用）,Bone-forming drugsParathyroid,Parathyroid hormone(PTH),application,Osteoporosis,Primary parathyroid function decline,(Intake vitamins D and calcium together),Generally applies only to first aid,Parathyroid hormone(PTH) Osteo,Androgen and anabolic hormone,mechaism,Androgen can promote the synthesis of protein and collagen, stimulate bone formation and retention of calcium, phosphorus, and potassium.,Androgen and anabolic hormoneA,Androgen and anabolic hormone,application,male osteoporosis,Side effect is bigger, the dose of treatment and the pros and cons of relationship is still in the further research,Androgen and anabolic hormonem,Mineralization drugs,Calcium,Adding bone mineral and promoting bone mineralization,vitamin D,3,Increase the absorption of dietary calcium and phosphorus, maintain the balance of calcium and phosphorus and increase the activity of osteoblasts,Mineralization drugsCalcium,Calcium,application,Acute or chronic hypocalcemia; Tetany disease,（手足抽,搐）,Rickets,（,佝偻病）,; Osteomalacia,（,软骨病）, osteoporosis, parathyroid function impairment,Magnesium poisoning counterpoison,（镁中毒解救）,(One key piece of advice is to take your calcium in several small doses throughout the day),.,CalciumapplicationAcute or ch,vitamin D,3,application,Osteoporosis,Chronic renal failure,For treatment and prevention,of vitamin D deficiency,Psoriasis,（,银屑癣）,vitamin D3applicationOsteopor,骨质疏松用药课件,Osteoporosis is a disease of bone that commonly occurs in elderly people, and is characterized by the degeneration of bone superstructure, a decrease of bone strength , an increase of bone fragility and thus an increased risk of fracture.,Drugs available for the prevention and treatment of osteoporosis are catalogued into three types in terms of their actions on affecting calcification and boneover.,Key Concepts,Osteoporosis is a disease of b,Antiresorptive agents, including bisphosphonates, calcitonin, estrogen and iprioavone which decrease the rate of bone loses through inhibiting the activity osteoclasts,（破骨细胞）,.,Key Concepts,The second group agents including fluoride,parathyroid hormone and androgens that promote bone formation by stimulating the activity of osteoblasts,（成骨细胞）,.,.,Antiresorptive agents, includi,Please describe the classification and characteristic of osteoporosis drugs?,Review questions,Please describe the classifica,