SBI4U-05 - Mr.

Wright

Summative Part 1
Huzefa Aziz Fatakdawala

Huzefa SBI4U

Summative Part 1 SBI4U

SBI4U Summative Part 1 DRUG NAME: Disodium Etidronate Introduction Etidronate Disodium (or Disodium Etidronate) is the disodium salt of (1-hydroxyethylidene) diphosphonic acid. It is abbreviated to EDHP. It belongs to a class of medicines known as bisphosphonates. It is known by the name Didronel in the consumer industry. Etidronate Disodium is also available as a generic medicine. The primary function of this drug is to regulate bone metabolism. It is a white powder, highly soluble in water, and has a molecular weight of 250. It is orally administered.

What does it treat? It acts primarily on the bone.

Pagets disease (Main) o In Pagets disease, bone breakdown is increased by osteoclasts and rate of new (and irregular) bone formation by osteoblasts. o The normal bone marrow also gets replaced with blood vessels and fibrous tissue. o Symptoms include pain and deformation in bones (thickening skull, spine etc.), higher heart rates, bone fractures and other vascular disorders. o The enlarged and deformed bones often put pressure on underlying nerves, causing pain and muscle weakness. Heterotopic Ossification o It occurs following a wide variety of trauma such as hip replacement surgery, spinal cord injury etc. o It may also take place in non-traumatic conditions such as infections of the central nervous system. Osteoporosis o It is characterized by low bone mass and deterioration of bone tissue. o This causes increased bone fragility and leads to fractures and in places such as the hip, spine and wrist. o It results in disfigurement, reduction or loss of mobility, and decreased independence.

Summative Part 1 SBI4U

Side Effects of the Drug It may cause irritation in the digestive tract (mainly the esophagus and intestines). To reduce the risk of this happening, it is important to swallow Didronel with a full glass of water. Higher doses may result in temporary renal impairment or permanent damage to the kidneys. Because of this, diarrhea may occur. Other common side-effects are rashes on the skin, nausea, headache and heartburn.

How does it work?

The drug is not metabolized in the digestive tract and only about 3% is absorbed. About 50% of the absorbed drug is excreted in the urine within 24 hours and the unabsorbed drug is excreted in the feces. The bone is constantly being maintained (repair jobs like rebuilding and reforming them). The cells constantly deposit and remove calcium and phosphorus. Old bone is broken down by osteoclasts and new bone is formed by osteoblasts. Didronel (Etidronate Disodium) binds tightly to the bone and prevents the calcium from being removed by osteoclasts. This stops the osteoclasts from breaking down the bone. It also reduces the action of the osteoblasts.

Clinical Trials To assess the efficacy of adding etidronate to calcium and vitamin D to treat low bone mineral density o This clinical trial took place over a period of 24 months and there were 154 patients who participated in this trial. o It was concluded that the addition of etidronate does not further enhance bone mineral density. To compare the efficacy and tolerability of etidronate and risedronate for treatment of Pagets disease o Risedronate is a drug that is often used to treat bone diseases like Pagets disease. It is administered in 5 mg tablets that are to be taken every day. o The study took place over a period of 18 months and there were 61 patients that participated in this trial. o It was concluded that though etidronate was effective, risedronate offered a shorter duration of therapy.

Summative Part 1 SBI4U

References
1. Miller, PD, JP Brown, ES Siris, MS Hoseyni, DW Axelrod, and PJ Bekker. Druglib.com - Drug Information, Research, Clinical Trials, News. Publication. Web. 01 Dec. 2011. <http://www.druglib.com/abstract/mi/miller-pd_am-jmed_19990500.html>. 2. Siffledeen JS, Fedorak RN, Siminoski K, Jen H, Vaudan E, Abraham N, Steinhart H, and Greenberg G. "Randomized Trial of Etidronate plus Calcium and Vitamin D for Treatment of Low Bone Mineral Density in Crohn's Disease." Druglib.com Drug Information, Research, Clinical Trials, News . Web. 01 Dec. 2011. <http://www.druglib.com/abstract/si/siffledeenjs_clin-gastroenterol-hepatol_20050200.html>. 3. "Didronel." NetDoctor.co.uk - The UK's Leading Independent Health Website. Netdoctor, 13 July 2006. Web. 01 Dec. 2011. <http://www.netdoctor.co.uk/medicines/100000765.html>. 4. Didronel. Publication. NJ: Warner Chilcott. Warner Chilcott. Web. 1 Dec. 2011. 5. "Bisphosphonates." Osteoporosis Canada. Web. 08 Jan. 2012. <http://www.osteoporosis.ca/index.php/ci_id/5516/la_id/1.htm>.