ABSTRACT
The increasing prevalence of osteoporosis is causing a substantial health burden. Compliance and adherence to osteoporosis management are of high priority, having a significant effect on the cost effectiveness of therapy. In this study, we aimed to summarize the literature on patient compliance in osteoporosis. Our findings indicate that 60% of the patients have some medication related problem, in particular, it is difficult to influence the patients to play an active role in their disease management and to keep a high level of persistence. Pharmaceutical care could help to reach optimal cooperation between patients and the heath care professional, as one of its main objective is to improve the rate of patient adherence in long-term drug therapy.
Subject(s)
Bone Density Conservation Agents/administration & dosage , Medication Adherence , Osteoporosis/drug therapy , Administration, Oral , Antibodies, Monoclonal/administration & dosage , Bone Density/drug effects , Bone Density Conservation Agents/economics , Cost-Benefit Analysis , Densitometry , Diphosphonates/administration & dosage , Estrogens/administration & dosage , Humans , Hungary/epidemiology , Infusions, Intravenous , Medical History Taking , Medication Adherence/psychology , Medication Adherence/statistics & numerical data , Osteoporosis/diagnosis , Osteoporosis/economics , Osteoporosis/epidemiology , Osteoporosis, Postmenopausal/drug therapy , Parathyroid Hormone/administration & dosage , Pharmaceutical Services/standards , Pharmaceutical Services/trends , Prevalence , Progesterone/administration & dosage , RANK Ligand/immunology , Recombinant Proteins/administration & dosage , Selective Estrogen Receptor Modulators/administration & dosage , Self Administration , Time FactorsABSTRACT
It has been reported recently (Tretter et al., 2007b) that in isolated guinea pig brain mitochondria supported by alpha-glycerophosphate (alpha-GP) reactive oxygen species (ROS) are produced through the reverse electron transport (RET) in the respiratory chain and by alpha-glycerophosphate dehydrogenase (alpha-GPDH). We studied the effect of calcium on the generation of H(2)O(2) as measured by the Amplex Red fluorescent assay in this model. H(2)O(2) production in alpha-GP-supported mitochondria was increased significantly in the presence of 100, 250, and 500 nM Ca(2+), respectively. In addition, Ca(2+) enhanced the membrane potential, the rate of oxygen consumption, and the NAD(P)H autofluorescence in these mitochondria. Direct measurement of alpha-GPDH activity showed that Ca(2+) stimulated the enzyme by decreasing the Km for alpha-GP. In those mitochondria where RET was eliminated by the Complex I inhibitor rotenone (2 microM) or due to depolarization by ADP (1 mM), the rate of H(2)O(2) formation was smaller and the stimulation of H(2)O(2) generation by Ca(2+) was prevented partly, but the stimulatory effect of Ca(2+) was still significant. These data indicate that in alpha-GP-supported mitochondria activation of alpha-GPDH by Ca(2+) leads to an accelerated RET-mediated ROS generation as well as to a stimulated ROS production by alpha-GPDH.
