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Used for treating established postmenopausal osteoporosis as well as hypercalcemia secondary to hyperparathyroidism, and pagets disease
Medication Names
Prototye Med |
calcitonin-salmon (Miacalcin, Calcimar) |
Drug Class: Hypocalcemic
Action: decrease bone resorption, inhibits the action of osteoclasts and increases excretion of calcium
Therapeutic Use
Treatment of postmenopausal osteoporosis |
Hypercalcemia secondary to hyperparathyroidism |
Paget’s disease |
Adverse Effects
Nasal dryness and irritation with intranasal calcitonin |
Hypersensitivity reactions/ anaphylaxis |
Hypocalcemia |
Decrease in therapeutic effects over time |
Nasal form of calcitonin may cause nasal dryness and irritation as well as headaches and epistaxis |
Injectable form may cause injection site reaction, nausea and vomiting and polyuria. |
Nursing Interventions
When administering intranasal calcitonin |
Alternate nostril used daily. |
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Assess prior to administration for irritation/ulceration. |
Prior to beginning therapy |
Perform intradermal allergy test. |
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Development of erythema within 15 minutes indicates sensitivity. |
Have epinephrine 1:1000, antihistamines, and oxygen available during early therapy |
Monitor for hypocalcemia (serum calcium level, muscle spasms, tingling of fingers and toes). |
Provide diet high in calcium and vitamin D. |
Administration
Intranasal spray |
Hold nasal pump upright. |
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If using pump for the first time, prime pump according to manufacturer’s instructions. |
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Spray once in nostril opposite of previous instillation |
Intramuscular/Subcutaneous |
Rotate injection sites. |
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Subcutaneous is preferred route - Administer IM if dose more than 2 ml |
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Protect from light. |
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Keep calcitonin salmon refrigerated. |
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Patient Education
For intranasal calcitonin, instruct clients to |
Alternate nostril used daily. |
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Report nasal irritation or bleeding. |
Instruct clients to immediately notify provider if rash or itching occurs. |
Instruct clients to do the following for 30 minutes after taking drug: report changes in swallowing or vision to provider |
Notify provider of muscle spasms, tingling of fingers and toes. |
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Eat a diet high in calcium and vitamin D. |
Monitor for loss of effect after a year or more of use through regular bone density studies |
Contraindicationsdications
Allergy to salmon |
Prior treatment with bisphosphonates |
Pregnancy and lactation |
Precautions
Safety not established in pediatric clients |
Interactions
May decrease serum lithium levels. |
Previous treatment with bisphosphonates may decrease the response to calcitonin. |
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