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DRUGS USED IN OSTEOPOROSIS & OBESITY. OSTEOPOROSIS A condition of skeletal fragility due to progressive loss of bone mass. Occurs in elderly of both sexes.> in post menopausal women Characterised by frequent bone fractures Diet – calcium & vit D. Avoid glucocorticoids. BIPHOSPHONATES
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OSTEOPOROSIS • A condition of skeletal fragility due to progressive loss of bone mass. • Occurs in elderly of both sexes.> in post menopausal women • Characterised by frequent bone fractures • Diet – calcium & vit D. • Avoid glucocorticoids
BIPHOSPHONATES • Analogs of pyrophosphate • Etidronate • Risedronate • alendronate
Biphosphonate decrease osteoclastic bone resorption by • Inhibition of osteoclastic proton pump • Decrease in osteoclastic formation/activation • Increased osteoclastic apoptosis
Biphosphonates given orally • Along with 8 ounces of water 1 hour before breakfast • Adv eff • Esophageal ulcers
TERIPARATIDE • Recombinant segment of human parathyroid hormone • Increases spinal bone density risk of vertebral fracture • Stimulates bone formation • Parathyroid hormone given continuously causes dissolution of bone but once daily sc causes bone formation.
SELECTIVE ESTROGEN RECEPTOR MODULATORS SERM • Most effective for post menopausal women • Prevents osteoporosis and reduces risk of hip fracture • Raloxifene increases bone density without increasing risk of endometrial cancer
Drugs used to treat obesity • Mainly 2 classes of drugs • Anorexiants—phentermione, sibutramine • Lipase inhibitor---Orlistat
Phentermine & sibutramine • Sympathomimetic amines • Interfere with reuptake of serotonin & NE into synaptic cleft • Undergo demethylation in the liver and are excreted primarily in the urine
Orlistat • Pentanoic acid ester – inhibits gastric and pancreatic lipases • Decrease fat absorption by 30 % • Loss of calories is the main cause of weight loss • Contraindicated in patients with chronic malabsorption syndrome
DRUGS USE TO TREAT ED • PDE-5 INHIBITORS • SILDENEFIL • TADALAFIL • VARDENFIL
Tadalafil– slower onset of action but enhances function for 36 hrs. • Not influenced by food or alcohol intake • Adv eff • Headache • No increase in incidence of MI • CI with organic nitrates
SILDENAFIL • BLUE/GREEN COLOR VISION LOSS • AFFECTS PDE-6