1. PHARMACY TECHNICIAN
CHAPTER TWENTY FOUR

2. Bone Composed of two different kinds of bony tissue
Cancellous or “spongy” bone—porous, inner bone that provides volume
Compact bone—hard, outer covering that provides strength and shape
The rounded end of a bone is covered with smooth, slippery articular cartilage
Many bones are hollow, and contain marrow:
Red marrow in children
Fatty yellow marrow in adults 2

3. Bone and Muscle

4. Types of Muscle
Skeletal muscles—attached to bones; provide body movement
Voluntary, striated in shape, contain multiple peripheral nuclei
Cardiac muscle—tissue that composes the heart
Contracts rhythmically, coordinated by transmission of electrical impulses from nerve to muscle fibers
Smooth or “visceral” muscle—attached to or lines other organs such as the stomach, intestines, lungs, and blood vessels 4

5. Five Categories of Bone:
Flat bones—generally more flat than round
Irregular bones—have no defined shape
Sesamoid bones—have cartilage or fibrous tissue mixed in
Short bones—generally cube-shaped
Long bones—the most common bone
Epiphysis (the rounded end of the bone)
Diaphysis (the main shaft or central part of the bone) 5

6. Disorders of the Bone Osteomyelitis
Bacterial Infection Inside the Bone Destroys bone tissue
Original site of infection is frequently in another part of body
Infection spreads to the bone via the blood
Osteoporosis—bone brittleness due to lack of calcium
Prevalent in postmenopausal women because of estrogen deficiency
Paget’s disease—changes the normal process of bone growth
Causes bone to break down more quickly and grow back softer than normal bone

7. Musculoskeletal Diseases/Disorders
Bursitis—inflammation of the small, fluid-filled pouches between bones
Tendonitis—inflammation of the cords of connective tissue that attach muscle to bone
Myalgia—muscle pain

8. Bone Marrow Disorders (cont.)
Anemia—failure of the bone marrow to produce red blood cells
Most common cause is lack of iron
Lack of red blood cells leads to a systemic decrease in oxygen
Causes fatigue
Leukemia—blood-borne cancer; cancer of the blood
Begins when DNA of white blood cells is damaged or mutated
Damaged DNA is copied and passed on to subsequent generations of cells
Abnormal, cancerous cells do not die off like normal cells
Multiply unchecked within the body

9. Arthritis—Inflammation of a Joint
Rheumatoid—an autoimmune disorder
Osteoarthritis—caused by physical degeneration of connective tissue
Gout—caused by crystals of uric acid in blood

10. Treatments Osteomyelitis
Anti-infective agent is best treatment for osteomyelitis
Osteoporosis
Vitamin D and mineral calcium replacement therapy
Hormone therapy (estrogen, calcitonin) and bisphosphonates
SERMs for postmenopausal women
Gold compounds used to treat osteoarthritis

11. Treatments
Gout
Colchicine used to alter ability of phagocytes to attack uric acid crystals
Anti-inflammatory analgesics can be used to reduce pain and inflammation
Inflammation
Salicylates relieve inflammation by inhibiting the synthesis of prostaglandin
Topical corticosteroids treat most causes, including chemical, mechanical, microbiological, and immunological

12. Treatments Multiple Sclerosis
Autoimmune disease in which body’s immune system begins to attack normal body tissue
Treatment of MS includes steroidal anti-inflammatory agents and corticosteroids
Cerebral Palsy
Affected person has poor control of the brain, muscles, and joints
Pharmaceutical therapy includes drugs to prevent seizures and spasticity

13. Musculoskeletal Pharmaceuticals
ASA (acetylsalicylic acid)
Relieves inflammation by inhibiting the synthesis of prostaglandin
Salicylates are also used as analgesics and antipyretics
NSAIDs (nonsteroidal anti-inflammatory drugs)
Inhibit or block the enzyme that starts the reaction of inflammation by making prostaglandin
COX-2 inhibitors
Block only the cyclooxygenase II that makes PGE-2, but not C-1 (PGE-1)
Inflammation is inhibited, but not the viscosity of the mucosal linin

14. Musculoskeletal Pharmaceuticals (cont.)
Antigout agents—may be hypouricemic agents or uricosuric agents
Hypouricemic agents decrease production of uric acid in the blood
Uricosuric agents increase the excretion of uric acid through urination
Calcitonin—indicated for fragile or soft bones
Inhibits bone resorption
Decreases the number of bone fractures from low bone density

15. Musculoskeletal Pharmaceuticals
Bisphosphonates—indicated for osteoporosis
Mimic the natural organic bisphosphonate salts found in the body
Inhibit bone resorption and osteoclast activity
Restore bone mass and density
SERMs (selective estrogen receptor modulators)
Indicated for postmenopausal women
Protective effect on bones and heart
Skeletal muscle relaxants—used to relax specific muscles in the body
Relieve pain, stiffness, and discomfort
Block muscle contraction at the neuromuscular junctio