Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Etidronate is in a class of drugs called
bisphosphonates that is used for treating osteoporosis (reduced density of bone
that leads to fractures) and bone pain from diseases such as metastatic
breast cancer, multiple myeloma, and Paget's disease. The bisphosphonate class includes
alendronate (Fosamax), ibandronate (Boniva), pamidronate (Aredia), risedronate
(Actonel), and tiludronate (Skelid). Bone is in a constant state of remodeling;
new bone is laid down by cells called osteoblasts while old bone is removed by
cells called osteoclasts. Bisphosphonates strengthen bone by inhibiting bone
removal by osteoclasts. After menopause, there is an increased rate of bone loss
leading to osteoporosis, and etidronate has been shown to increase bone density
and decrease fractures of bones. The FDA approved etidronate in September 1977.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 200 and 400 mg.
STORAGE: Etidronate should be stored at room temperature, 15-30 C (59-86 F).
PRESCRIBED FOR: Etidronate is used for treating Paget's disease and
preventing heterotopic ossification. Heterotopic ossification is a process in
which bone is deposited in soft tissues and muscles, usually after
hip
replacement or spinal cord surgery. Non-FDA approved (off-label) uses include
hypercalcemia (increased blood levels of calcium) associated with cancer,
prevention of steroid induced osteoporosis, and postmenopausal osteoporosis.
DOSING: The recommended dose for adults is 5-20 mg/kg daily. Food
(especially, calcium rich foods such as dairy products), antacids,
vitamins with
mineral supplements, and certain medications can interfere with the absorption
of etidronate. Therefore, etidronate should be taken on an empty stomach 2 hours
before or after eating, or taking other medications.
DRUG INTERACTIONS: Calcium replacement products (for example, calcium
chloride, calcium gluconate, and calcium carbonate) and antacids (for example,
aluminum hydroxide) reduce the absorption and effects of etidronate.
PREGNANCY: The safety and effectiveness of etidronate has not been
established in pregnant women.
NURSING MOTHERS: The safety and effectiveness of etidronate has not been
established in nursing mothers.
SIDE EFFECTS: Common side effects of etidronate include stomach pain, nausea,
vomiting, bloating, constipation, diarrhea, rash, hair loss, and muscle or
joint pain. Etidronate may worsen existing stomach or
intestinal ulcers. Rarely,
patients may experience jaw problems (osteonecrosis of the jaw) associated with
delayed healing and infection after tooth extraction. Severe skin reactions,
seizures, as well as decreased red and white blood cell levels occur rarely.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Paget's disease is a chronic bone disorder due to irregular breakdown and formation of bone tissue. Symptoms of Paget's disease include bone pain, headaches and hearing loss, pressure on nerves, increased head size, hip pain, and damage to cartilage of joints.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Hypercalcemia is a condition in which calcium levels in the blood are elevated. Hypercalcemia is associated with other conditions such as hyperparathyroidism, lung cancer, breast cancer, kidney failure, and elevated levels of vitamin D. Symptoms of hypercalcemia include constipation, nausea, abdominal pain, kidney stones, to name a few. Treatment depends on the cause of hypercalcemia.
When vertebrae are broken or dislocated, the result can cause traumatic injury to the spinal cord. A spinal cord injury can have significant physiological consequences. One indication of the severity of a spinal cord injury are respiratory complications. Spinal cord injuries are classified as either complete or incomplete. A spinal cord injury can affect breathing, lead to pneumonia, low blood pressure, irregular heart beat, blood clots, spasms, autonomic dysreflexia, bed sores (pressure sores), chronic pain, bladder and bowel problems, and reproductive and sexual function issues. Rehabilitation and recovery of a spinal cord injury is dependant upon the type of injury.
Premature menopause is when a woman goes through menopause before the age of 40 because of genetics, illness, or a medical procedure. Symptoms of premature menopause include irregular or missed periods, mood swings, hot flashes, periods that are heavier or lighter than usual, vaginal dryness, bladder irritability, incontinence, dry skin, eyes or mouth, sleeplessness, and decreased sex drive. Though premature menopause cannot be reversed, the symptoms can be managed with methods similar to those used for natural menopause.
Surgical menopause happens when a premenopausal woman has her ovaries removed in a surgical procedure called a bilateral oophorectomy. An abrupt menopause follows, with women often experiencing more severe menopausal symptoms than if they were to go through natural menopause. Chemotherapy and pelvic radiation therapy may also cause menopause by damaging the ovaries.
Menopause is defined as the state of an absence of menstrual periods for 12 months. The
menopausal transition starts with varying
menstrual cycle length
and ends with the final menstrual period. Perimenopause means "the time around menopause"
and is often used to refer to the menopausal transitional period. It is not officially a medical term, but is sometimes used to
explain certain aspects of the menopause transition in lay terms. Postmenopause
is the entire
period of time that comes after the last menstrual period.
Menopause is the time in a woman's life when the function of the ovaries
ceases. The ovary (female gonad), is one of a pair of reproductive glands in
women. They are located in the pelvis, one on each side of the uterus. Each
ovary is about the size and shape of an almond. The ovaries produce eggs (ova) and female
hormones such as estrogen. During each
monthly menstrual cycle, an egg is released f...