Short Answer
- Physiology of Bone
Basic mechanism charged for advancement of Osteoporosis are poor mass of the bone acquisition in growth and development and fast bone loss at the time after optimum bone mass is acquired. These factors are modulated by the environment and genetic elements. The Mammalian bones can be categorized as long, short, flat, or irregular (Dempster, 2006). The long bones that comprise of femurs, are a bigger component of the human skeletal and meet several varied roles. In addition to safeguarding soft tissues and determining posture, long bones similarly have the ability to offer a site for haematopoiesis. Additionally, they are vital sites of mineral storage, more so calcium and phosphate. The varied roles of bone needed a flexible framework to manage the mineral storage and adapt to environmental stress. Due to this reasons, osseous tissue is gradually broken down and re-deposited in a process called ‘remodelling’.
Bone remodelling
Healthy adult bone, matrix there is a flexible equilibrium of deposition of osteoblasts and resorption through osteoclasts. The latter characteristically combined together and do away with bone in an extended period of time of approximately 3 weeks. This leaves a tunnel of about 0.2 mm and 1mm. Osteoblasts later acts to deposit a new matrix and these cells can be seen to acting on 4% of the surface of an adult bone at any period of time (Dempster, 2006). New bone is placed in the concentric circles called lamellae and it is through this that, about 10% of bone is re-deposited in the adult skeleton on an annual basis. The objective of the progressive bone remodeling is based on two aspects:
There is the transformation of the shape of the bone and thickness in reaction to the setting and musculoskeletal stresses and there is replenishment of old bones that are weaker when compared to the freshly deposited matrix. The structural and functional impact of this process is visual impairment, impaired cognition, and postural hypotension, as well as frailty.
- A good number of modifiable risk factors come about due to unhealthy life choices hence affecting the person’s bone biology and leads to a drop in bone mineral density (BMD). Some of these factors similarly lead to a rise in risk of fracture independent of the impact on bone.
People with a history of cigarette smoking and those that smoke are at a high threat of fracturing their bones when they ate compared to those that do not smoke (Kanis et al, 2005). Smoking affects Mr O’reilly’s balance of the naturally occurring processes of bone resportion and bone formation, this results to a reduced BMD since the size resorbed is not completely replaced.
- Alendronate is a bisphosphonate bone resorption inhibitor used in the treatment of osteoporosis disease of the bone. Its mechanism of action is that it inhibits osteoclastic bone resorption. The treatment is taken orally using food or drinks. Part of the absorbed drug is integrated into the bone.
The medication is administered in quantity of 10mg daily. The drug should be taken in an empty stomach with not less than 200ml of water in AM, the patient should keep in an upright position for about 30 minutes after taking food to safeguard against esophageal injury (Metcalfe, 2008). The nurse ought to assess the serum calcium levels prior, in the course and after therapy, additionally they are to offer comfort if bone returns as well as sufficient vitamin D and calcium intake.
While taking the drug, the patient may feel certain side effects; Nausea, and bone pain, the patient should take analgesic (Therapeutics Initiative, 2010). Additionally, the nurse should ensure that the patient is not allergic to the drug as it comprises of inactive elements that may lead to allergic reactions or other issues. The nurse should hence take the medical history of the patient more so disorders, difficulty in swallowing, issues on sitting upright, low calcium and internal disorders like ulcers.
References
Dempster DW (2006). Osteoporosis in men. In: Favus MJ, editor. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. Washington DC: The American Society for Bone and Mineral Research.
Kanis JA, et al (2005). Smoking and fracture risk: a meta-analysis. Osteoporosis Int.;16:155-62
Metcalfe, D. (2008). The pathophysiology of osteoporotic hip fracture. Mcgill J Med.11(1): 51–57.
Therapeutics Initiative (2010). New Drugs III. Retrieved on 7th March 2014 from: http://www.ti.ubc.ca/newsletter/new-drugs-iii-%E2%80%93-alendronate- fosamax%C2%AE-dorzolamide-trusopt%C2%AE-acarbose-prandase%C2%AE- olanzapine-z
