Osteoporosis lead effect

Due to its anti-resorptive effects, calcitonin has been widely used to treat a variety of metabolic bone diseases, including osteoporosis. However, the availability of more potent drugs has lead to a decline in the clinical use of calcitonin. 

In leukemia, the intensified use of methotrexate and glucocorticoids is responsible for causing an increased frequency of neurotoxicity and, in older children and adults, avascular necrosis of bone. High cumulative doses of anthracyclines can cause cardiomyopathy. Cranial irradiation causes neuropsychologic deficits and endocrine abnormalities that lead to obesity, short stature, precocious puberty, and osteoporosis.3 As newer and more intensive treatments enter clinical trials, close observation for long-term side effects will assume even greater importance.24... 

At menopause, the production of estrogens in females is markedly reduced. This leads to a number of unpleasant effects, including hot flashes and night sweats. More important for long-term health, the estrogen decrease is associated with an increased risk of cardiovascular disease and osteoporosis. The action of estrogens decreases plasma cholesterol and helps maintain good bone mineral density. 

Figure 13.32 The female triad disordered eating, osteoporosis and menstrual cycle disturbance. A low energy intake and high energy expenditure can Lead to endocrine changes that result in osteoporosis and disturbance in the menstrual cycle. A low energy intake in female runners, rowers or gymnasts in order to maintain a low body weight can lead to other disturbances in eating such as bulimia or anorexia nervosa. Stress may contribute to energy imbalance and may have additional effects on the hypothalamus.

Steroids have mineralocorticoid and glucocorticoid effects. Betamethasone has little, if any, mineralocorticoid effect. However, it should be used with caution in patients predisposed to hypertension since mineralocorticoid effects may lead to sodium and water retention and an increase in blood pressure. When used systemically, especially at high doses, steroid therapy is associated with a risk of psychiatric reactions such as euphoria, irritability, mood lability and sleep disorders. Glucocorticoid side-effects include diabetes and osteoporosis. 

Uses Chronic asthma Actions Topical steroid Dose Two inhalations tid-qid or 4 inhal bid Caution [C, ] Contra Component aU gy Disp Met-dose inhaler SE Cough, oral candidiasis Interactions T Risk of GI bleed W/ ASA, NSAIDs T effects W/ sakneterol, troleandomycin -1- effects W/barbiturates, hydantoins, pheny-toin, rifampin T effects OF diuretics, insulin, oral hypoglycemics, K supl, salicylates, somatrem, live virus vaccines EMS May affect glucose(hyperglycemia) monitor ECG for hypokalemia (flattened T waves) concurrent ASA/NSAID use may t risk of GI bleeding OD Acute OD unlikely to cause life-threatening Sxs, chronic OD may lead to S/Sxs of muscle weakness, and osteoporosis symptomatic and supportive... 

Mechanism of Action A bisphosphonate that inhibits normal and abnormal bone resorption, without retarding mineralization. Therapeutic Effect Leads to significantly increased bone mineral density reverses the progression of osteoporosis. Pharmacokinetics Poorly absorbed after oral administration. Protein binding 78%. After oral administration, rapidly taken into bone, with uptake greatest at sites of active bone turnover. Excreted in urine. Terminal half-life Greater than lOyr (reflects release from skeleton as bone is resorbed). 

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