Bisphosphonates are widely applied across the world in metastatic bone disease and treatment of bone diseases such as osteoporosis and Paget 's disease. They are classified as an anti-resorbitive drug, which defines that they slow/stop the natural processes which dissolve the bone tissue. The main impact of the drug, is to reduce the osteoclastic activity and to act upon the suppression of bone remodelling, thereby decreasing the destructive effects which accompany bone disease.
Understanding the role in which bisphosphonates plays in the remodelling of bone is key to understanding whether it has a potential impact in a medico-legal setting. Exploration into the full extent, by which bisphosphonates effects the skeletal elements of the human body is to be determined in full depth and whether there is an impressionable impact on the skeleton at any given time. This will be achieved by searching through already published work in medical journals and articles on bisphosphonates. Developing on aspects such as: their clinical use, epidemiology, interaction with bone remodelling and impact on the growing skeleton.
Formation of this dissertation, is part of a wider body of work to assess the impact of a variety of pharmaceuticals, on the composition of bone and the morphology of the human skeleton. To this end, a common section on normal bone was written by CAHID staff and is incorporated here for the sake of conformity across the dissertations and to permit concentration on the specifics of Bisphosphonates.
Bone is a living tissue with a matrix composite which incorporates a mineral or inorganic phase of primarily calcium phosphate (hydroxyapatite) and an organic phase comprised of primarily collagen which is...
... middle of paper ...
...about a steady 10% of bone volume per year providing there are no catastrophic events or biochemical insults.
Therefore when looking at the introduction and long term effects of pharmaceuticals on the composition of bone there are a number of factors which should be taken into account if a) the chemical profile of bone is to be considered or b) morphological changes are to be taken as proxy indicators of the use of the substance.
* The age and sex of the individual when ingestion/inhalation/injection commenced
* The duration of the activity
* The intensity of the activity
* The cessation of the activity in relation to both the age and sex of the individual
* The health of the individual
* The nature of the pharma
* The effects on compact bone where turnover is slower
* The effects on cancellous bone where turnover is quicker
© S M Black 2014. University of Dundee
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