Osteoporosis

Osteoporosis, which comes from Greek meaning porous bone, is a condition or disease process that is marked by structural deterioration of bone tissue and low bone mass. Low bone mass can lead to bone fragility and increase risk of fractures
Clinical Features
a "silent disease" (i.e., there are frequently no symptoms) until a fracture has occurred. As the disease progresses, symptoms may include
back pain,
fractures,
loss of height,
skeletal deformity (kyphosis or kyphoscoliosis),
neck strain (due to an exaggerated cervical lordosis),
midabdominal pain (caused from the ribs resting on the iliac crest),
alterations in bowel function,
Risk factors
Postmenopausal women
Elderly age
Personal Medical History and Family History
Hormonal abnormalities, such as hyperthyroidism, and hyperparathyroidism can impair the bone-making process
Individuals with a history of neoplastic disorders, such as multiple myeloma,
Nutritional deficiencies,inadequate calcium or vitamin D intake,
Lifestyle Factors
Pharmacologic Risk Factors
Phenytoin sodium (Dilantin)
Glucocorticoids
Medroxyprogesterone acetate (Depo-Provera)
Nonpharmacologic Interventions

Lifestyle modification
Weight-bearing exercises
Nutrition

Pharmacological interventions
hormone replacement therapy
bisphosphonates,
calcitonin,
selective estrogen receptor modulators,
fluoride supplementation

ERT/HRT
ERT/HRT has been shown to prevent osteoporosis by decreasing the bone loss that is common after menopause,
new studies have indicated that although ERT/HRT may prevent bone loss, there is no concrete evidence to support its use as a treatment modality because of unacceptable increased incidence of breast cancer noted in the women who used HRT
women with osteoporosis, other pharmacologic interventions may be preferred
Bisphosphonates
Alendronate,Etidronate,Pamidronate

Mechanism of action:
Inhibits bone resorption by binding to hydroxyapatite crystals
Accelerated apoptosis of osteoclasts
Disruption of cytoskeleton and ruffled border of osteoclasts
Inhibits osteoclasts differentiation by suppressing IL-6

Precaution needed with BPN Prevent conatct with oesophageal mucosa

Second/third generation BPN Zolendronate,Risedronate