الفهرس 
OsteoporosisOnly 14 pages are availabe for public view
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Abstract
Osteoporosis is an impairment in bone strength due to an abnormal quantity, quality of bone, or both.
Osteoporosis is a major public health problem through its association with fragility fractures which is the most significant complication of osteoporosis. While fractures may occur at many sites, they most commonly occur in the hip, spine, and wrist.
Fractures associated with osteoporosis have a high predilection in females and are related to the patient’s age. While vertebral fracture is the most common type of osteoporotic fracture, hip fractures have a particularly high morbidity and mortality rate. Fracturing a hip is a major concern in many older people, in that it makes it difficult for the individual to perform necessary activities of day living (ADLs) and limits independence, and secondary complications may even lead to death.
Despite the availability of preventative therapeutic agents, the incidence of osteoporosis and its associated costs continue to rise globally.
Osteoporosis may be primary osteoporosis and it is classified in to Juvenile osteoporosis and Adult osteoporosis. Adult osteoporosis is also classified in to Type I osteoporosis (postmenopausal) and type 11 osteoporosis (senile osteoporosis). Secondary osteoporosis reflects bone loss that is a result of another clinical problem such as osteoporosis with endocrine diseases. It occurs in men and women at any age.
As osteoporosis has no obvious symptoms other than a fracture when the bone is already significantly weakened, it is important to look for the risk factor
That is why high alerts for prevention and early diagnosis is needed early. Any individual patient’s risk of a fracture is dependent upon a variety of factors. First, the patient’s propensity to fall is an extremely important risk factor for fracture. Second, bone strength is another important determinant of fracture risk. Bone strength is related to (BMD) as well as other properties of bone that are often termed “bone quality” and matrix and mineralization properties.
Prevention of osteoporosis should begin in childhood and continue throughout adulthood. Treatment is aimed at reducing future fracture risk and should be tailored to the individual patient. The emphasis should be on early recognition and effective management of patients at high fracture risk.
Treatment strategies in the management of osteoporosis include counseling all patients on lifestyle management, and emphasizing the importance of adequate daily intake of calcium and vitamin D.
Significant advances in bone biology in the past two decades have helped in understanding the pathogenesis of osteoporosis, leading to better therapies. A number of drugs are now approved for treatment of osteoporosis such as:
Antiresorptive drugs, Raloxifene is the only SERM approved worldwide for the prevention and treatment of postmenopausal osteoporosis. Ospemifene, lasofoxifene, bazedoxifene, and arzoxifene, which are new SERM molecules with potential greater efficacy and potency than previous SERMs, are currently under investigation for use in the treatment and prevention of osteoporosis.
Bisphosphonate (alendronate, risedronate, and zoledronic acid) therapy should be considered first-line therapy for the treatment of osteoporosis. They produce their anti resorbtion effect by inhibition of osteoclast activity on the surface of the bone.
Calcitonin (salmon) should be considered as a second- or third-line agent in patients with intolerance to bisphosphonate therapy. Calcitonin has analgesic effects that provides minimal support to help with pain in patients with osteoporosis.
Anabolic drugs, the recombinant human parathyroid hormone, teriparatide, is currently the only available bone anabolic agent. Parathyroid hormone functions to regulate bone metabolism, facilitate reabsorption of calcium and phosphate in the renal tubule, and control gastrointestinal calcium absorption, and increase 1,25-dihydroxy vitamin D. Also parathyroid hormone receptors have been found on osteoblasts, describing its anabolic properties.
Osteoporosis mainly affects older people but it can affect someone of any age. Some people have an increased risk of developing osteoporosis in later years. Measures should be taken to prevent or slow down bone loss. In certain people with osteoporosis, medication may be suggested to help restore some bone. Furthermore, early diagnosis will lead to better outcome and reduce experience of the disease.