Introduction
Chelate means claw in Latin. Metal Chelation is a process when a polyvalent metal ion form covalent bonds with a drug and binds tightly to form a 5 or 6 membered ring. 5 and 6 membered ring structure are very stable because their bond angle has no ring strain. Thus, when a compound is chelated, it will not be able to pass through the biological membrane, in another words, it will not be metabolise by the body but to be pass through the renal without being absorbed and being excreted though urine. Essential metal such as magnesium, iron, calcium and zinc are easily found in many food source and is vital to be included as part of our diet as these trace elements are helping our body enzymes, hormones and cells to work. Insufficient intake of trace minerals can cause symptoms of nutritional deficiency. (Glusker,1999) At certain times, these metal are also use as an active ingredient or excipients in pharmaceutical industry.
Chelation of Alendroic Acid with Calcium
Alendronic acid is a bisphosphonate drug that is used to inhibit osteoclastic bone resorption .it works by attaching to hydroxyapatite binding sites to impair the ability of the osteoclasts to produce the protons necessary for continued bone resorption. It also inhibit osteoclast activity by promoting osteoclast apoptosis. (pubmed ) Patient group who are mostly taking this medication are postmenopausal women. As women reaches their menopausal age, oestrogen starts to deplete which causes their bones to
1. A 12 year-old boy fell while playing basketball. The physician explained that the head
Before starting pharmacological medication preventive measures should be taken. For example, weight-bearing exercise, calcium and vitamin D intake, quit smoking and alcohol. After that start osteoporosis medication if it is primary, but if it is secondary treat the underlying cause first. These drugs do not treat osteoporosis, but decrease further loss of BMD which include Bisphosphonates (Alendronate- Risedronate- Ibandronate- Zoledronic acid), Raloxifene (Selective estrogen receptor modulators), Calcitonin (hormone decreases bone resorption by inhibiting osteoclast activity), Denosumab, Teriparatid(Parathyroid hormone). The first drug used is alendronate because of its high efficacy in preventing fractures and low cost. If the first line drug failed other bisphosnates or denosumab can be used. Ralaxofeine used as third line drug because it has a risk of developing blood clot diseases, yet it decreases the risk of breast cancer . Calcitonin is used for those who are contraindicated to the previous drugs because of its low efficacy. Teriparatid is the only drug that works by increasing BMD, but is the last drug used. It is taken for a maximum 2 years and expensive and contraindicated in those who have history or having a bone cancer. For those patients who complain of sever back pain surgery might be suitable for them as a last solution although the efficacy and safety
Osteoporosis is the most widely recognized bone malady known, influencing an expected 200 million individuals overall. Around 30% of every single postmenopausal women are influenced and up to 40% will add to a delicacy break inside their lifetime. After some time, various danger components have been connected with osteoporosis and are helpful when utilized in screening devices and treatment calculations. Diabetes, albeit distinguished more than a large portion of a century back as being connected with bone slightness, has go to the cutting edge just inside of the most recent decade as a vital osteoporosis hazard elements.
Of late, there has been renewed interest in the influence of acid-base balance on bone metabolism and the development of osteoporosis. The acid-ash hypothesis suggests that diets that are high in "acid-ash"(i.e. acid-forming) components(including dietary protein, phosphorus, and chlorine) and low in base-forming components(including fruits and vegetables, potassium, and calcium) generate acidic byproducts. To neutralize excess acid and prevent systemic acidosis, bone mineral is dissolved, bicarbonate is released, and calcium is expelled in urine, accelerating the development of osteoporosis. The "alkaline diet" encourages the consumption of base-forming foods and has been promoted as an effective method of reducing the risk of osteoporosis (WebMD 2013).
Osteoporosis is a treatable disease, but not a curable one. There are different types of treatment for osteoporosis. Some of the medications that can be taken for treatment of osteoporosis are estrogen, bisphosphonates, calcitionin, raloxifene, parathyroid hormone, and testosterone replacement (UCSF Medical Center, 2010). Some of the more common names for bisphosphonates are Fosamax, Actonel, Boniva, and Reclast (Mayo Clinic, 2009). These treatments are taken orally once a week or once a month. In addition to the medications, there is also the treatment of exercise and diet. With a diet high in calcium, stopping unhealthy habits, like smoking and drinking, and regular exercise can reduce the likelihood of bone fractures in people with osteoporosis (The New York Times, 2010). In Ms. Duckworth’s incident, it would be recommended that she increase the amount of calcium in her diet and exercise, and depending on the severity of the osteoporosis, medication.
Osteoporosis is a disorder of bones that affects bones making them low in bone mass fragile and will lead to bone fracture. Bone fracture will easily occur as this disease cause the matrix inside the bone become weak and brittle.Bones can become so brittle due to activities such as coughing can cause fractures.According to Macgill (2015) the origin of the word osteoporosis explain the condition of ‘osteo’ is for bone and ‘porosis’ means porous that resulting in weakness. At this condition, the bone tissue is mineralized normally, but the production is not enough to preserve the normal skeletal architecture. 80% of women and 20% men of 28 million American are affected with the osteoporosis. Approximately, women with the age of 50 will develop osteoporosis. Thin bones are the cause of 1.5 million fractures a year. As in Malaysia, the statistic shows that osteoporosis related to fractured is the common health problem especially in elderly..
As generally stated in the introduction, osteoporosis is a skeletal disorder that involves the strength and integrity of one’s bones. The WHO defines osteoporosis as, “a systemic skeletal disorder characterized by low-bone mass, deterioration of bone tissue, increased bone fragility, and its susceptibly to recurrent fractures.” 2 The most important factor to take into account when addressing osteoporosis is the mass of bone, also referred to as, bone mineral density (BMD). As bone mass begins to decline, typically in the older population, specifically postmenopausal women, individuals are at an increased risk for fractures.3 As a result of this serious condition, many people are affected by morbidity, mortality, and economic difficulty.1
Osteoporosis, also known as porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue which leads to bone fragility and an increased risks of the hip, spine, and wrist. Both men and women are affected by this (although it affects women more) but it can be prevented and treated. In the United States, more than 40 million people either already have osteoporosis or at a high risk because of low bone mass.
Osteoporosis is a degenerative disease of the bones generally brought on by the process of aging, unfortunately there can also be a number of underlying or secondary causes; however, preventative care and drug treatments can minimize the severity of this prevalent disease. Osteoporosis has been estimated to affect more than 200 million people worldwide (Bethel, 2015). According to the National Osteoporosis Foundation, 9.9 million Americans have osteoporosis and an additional 43.1 million have low bone density.
Slowing the rate of calcium and bone loss, therefore stopping the disease processes are the goals in the treatment of osteoporosis. Medications should be considered from the following selections. Bisphosphonates (e.g. alendronate, etidronate, risedronate, zoledronic acid) are the medications of choice for treating osteoporosis. Bisphosphonates help decrease the bone destruction by inhibiting hydroxyapatite breakdown, and increase bone mineralization, therefore increasing bone density (Medical Services
Diet and exercise are pivotal in the maintenance of bone mass density (BMD), there now several bisphosphonates that can be used to improve BMD. An increase of dietary vitamin D, K and Calcium will also help to strengthen the tight coupling relationship between osteoclasts and osteoblasts which will help to maintain healthy bone structure.
Osteoporosis is commonly known around the world as the numbers continue to increase every year. Osteoporosis is known to cause problems in middle aged women and occasionally effecting some men (1), currently reaching the number of 200million women diagnosed with osteoporosis (2). Arthritis Organisation states that anyone can get osteoporosis but women are about four times more likely than men to develop it, with two main reasons contributing to this fact. For several years after menopause occurs (ovaries stop producing oestrogen), the process of bone loss speeds up, increasing the chance of being diagnosed with osteoporosis. Yet men generally reach a higher level of bone density before the process of bone loss begins. Although
Progressive hepatolenticular disease, or more commonly known as Wilson’s Disease, is a rare autosomal recessive genetic disorder of copper metabolism that is characterized by hepatic and neurological disease. While there is no cure for Wilson’s Disease, there are several treatments that can effectively manage the symptoms. The predominant form of treatment for Wilson’s Disease is heavy metal toxicity medication which utilize copper chelators to prompt the organs in the body to release copper into the bloodstream and excreted via urine after kidney filtration or zinc to reduce copper absorption (Ala et. al, 2007). Medications for Wilson’s Disease include penicillamine, trientine, and zinc acetate. Besides medications, other current therapeutic
They are also studying how the metal-protein interaction plays a role in developing and increasing the toxic protein in which it becomes very hard to be cleared from the body. These interactions lead them to think about a drug that can prevent the linkage between metal and the protein or cleavage the bond between them and they found out that the metal chelation method is one of the most important and useful methods to decrease the oxidative stress and the toxic amyloid-β
Studies have shown that both estrogen and raloxifene, a Selective Estrogen Receptor Modulator, can prevent the loss of bone mass in postmenopausal women. Alendronate, a bisphosphonate is an alternative to estrogen for bone protection. Calcitonin is another treatment used by women for osteoporosis. This drug has been shown to slow bone breakdown and also may reduce the pain associated with osteoporotic fractures. Treatments under investigation include other bisphosphonates, sodium fluoride, para-thyroid hormone, vitamin D metabolites, and other selective estrogen receptor modulators.