about Calcitonin class, uses, side effects contraindications

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Calcitonin

Short Description

Calcitonin is a hormone secreted by the thyroid gland, which reduces the loss of calcium from the bones and helps maintain healthy levels of calcium in the blood.
The synthetic preparation of calcitonin is used to treat?osteoporosis?, Paget's disease, and high blood calcium.

Pregnancy category: C

Indications

To treat hypercalcemic emergency I.M.OR SUBCUTANEOUS INJECTION
Adults. Initial: 4 international units/kg every 12 hr. Increased after 1 or 2 days, if needed, to 8 international units/kg every 12 hr. Maximum: 8 international units/kg every 6 hr. To treat postmenopausal osteoporosis I.M.OR SUBCUTANEOUS INJECTION(CALCITONIN, SALMON)
Adults.Initial: 100 international units daily, every other day, or 3 times weekly. Maximum: 100 international units daily.
NASAL SPRAY
Adults. 200 international units (1 spray) daily, alternating nostrils. To treat Paget’s disease of the bone I.M.OR SUBCUTANEOUS INJECTION(CALCITONIN, SALMON)
Adults.Initial: 100 international units daily. Maintenance: 50 to 100 international units daily or every other day. Maximum: 100 international units daily. SUBCUTANEOUS INJECTION(CALCITONIN, HUMAN)
Adults.0.5 mg daily, 0.5 mg 2 or 3 times/ wk, or 0.25 mg daily. Route Onset Peak Duration I.M., SubQ In 15 min* 2 hr 6–8 hr

Mechanism of Action

Directly inhibits bone resorption. Besides reducing the serum calcium level, this action slows bone metabolism (a major factor in the development of Paget’s disease) and calcium loss from the bone (a major factor in the development of osteoporosis).

Contraindications

Hypersensitivity to calcitonin, human; calcitonin, salmon; or their components

Interactions

lithium: Possibly decreased lithium level calcitonin 166 * For hypercalcemia; 6 to 24 mo for Paget’s disease. For hypercalcemia; unknown for other indications.

Side Efect

CNS: Agitation, anxiety, dizziness, headache, insomnia, neuralgia, paresthesia, stroke, vertigo
CV: Bundle-branch block, hypertension, MI, palpitations, peripheral edema, tachycardia, thrombophlebitis
EENT: Blurred vision; dry mouth; earache; epistaxis; eye pain; hearing loss; nasal irritation, lesions, or redness; pharyngitis; rhinitis; salty taste; sinusitis; taste perversion; tinnitus; vitreous floaters
ENDO: Goiter, hyperthyroidism
GI: Abdominal pain, anorexia, cholelithiasis, diarrhea, epigastric discomfort, flatulence, gastritis, hepatitis, increased appetite, nausea, thirst, vomiting
GU: Hematuria, nocturia, pyelonephritis, renal calculi
HEME: Anemia
MS: Arthritis, arthrosis, back pain, joint stiffness, polymyalgia rheumatica
RESP: Bronchitis, bronchospasm, cough, dyspnea, pneumonia, upper respiratory tract infection
SKIN: Alopecia, diaphoresis, eczema, flushing of face or hands, pruritus of earlobes, rash, ulceration
Other: Anaphylaxis, anaphylactic shock, angioedema, antibody formation, feverish sensation, injection site inflammation, lymphadenopathy, mild tetanic symptoms

Cautions

If sensitivity to calcitonin, human; calcitonin, salmon; or their components is suspected, expect to perform a skin test before giving drug. Prepare a mixture of 10 international units/ml by withdrawing 0.05 ml from a 200–international units solution in a tuberculin syringe and filling the syringe to 1 ml with sodium chloride for injection. Mix well, discard 0.9 ml, and inject 0.1 ml intradermally on the inner forearm. Observe the site for 15 minutes after injection. If you detect evidence of sensitivity, such as more than mild erythema or a wheal, notify prescriber.

If patient receives calcitonin for hypercalcemia, monitor serum calcium level. During first several doses, keep parenteral calcium available in case the calcium level is inadvertently overcorrected.

If prescribed calcitonin dose exceeds 2 ml, expect to use I.M. route and multiple injection sites.

For patient receiving calcitonin for postmenopausal osteoporosis, also expect to give 1.5 g supplemental calcium carbonate and at least 400 units vitamin D daily. Plan to provide a balanced diet that includes high in calcium and vitamin D.

Assess for nausea, especially with the first dose. Nausea tends to decrease or disappear with continued use.

If patient with Paget’s disease relapses after treatment, check for antibody formation, as ordered.

PATIENT SAFTY

Tell patient to refrigerate injection or unopened
NASAL SPRAY container.

Teach patient to self-administer injections.

If patient has postmenopausal osteoporosis, teach her about dietary needs, including rich in calcium and vitamin D.

For
NASAL SPRAY, explain how to activate nasal pump by holding the bottle upright and depressing two white side arms toward the bottle six times. When bottle emits a faint spray, pump is activated. Tell patient to store activated nasal pump upright at room temperature and to discard it after 30 days.

Instruct patient to place nozzle firmly into one nostril while holding head upright. Tell him to then depress the pump toward the bottle.

Remind patient that he doesn’t need to reactivate the pump before each dose.

Instruct patient to report nasal symptoms, such as redness, lesions, sinusitis, and rhinitis, to prescriber.

Trade Name & Company Name

Trade name	Company name
MIACALCIC 200IU NASAL SPRAY	DELPHARM HUNINGUE SAS
MIACALCIC 100 IU-ML AMP	NOVARTIS
MIACALCIC AMP 50 IU-ML	NOVARTIS
CALCITEC 100 IU NASAL SPRAY	TABUK PHARMACEUTICAL MANUFACTURING CO.
CALCITEC 200 IU NASAL SPRAY	TABUK PHARMACEUTICAL MANUFACTURING CO.
CALCITEC 50 IU NASAL SPRAY	TABUK PHARMACEUTICAL MANUFACTURING CO.

effect of Calcitonin in Pregnancy, Fetal Health and Breast feeding

Pregnancy

. Calcitonin regulates calcium homeostasis. There are no adequate reports or well-controlled studies in pregnant women.

Fetal Health

There are no adequate reports or well-controlled studies in pregnant women. Calcitonin does not cross the placenta. The mechanism by which high doses of calcitonin produce IUGR in rabbits is unknown.

Breastfeeding

There is no published experience in nursing women. Calcitonin inhibits lactation in animals. It is unknown whether calcitonin enters human breast milk, though the high molecular weight argues against it. Further, any calcitonin in the milk would be destroyed by gastric acid. Procalcitonin is a normal constituent of human breast milk.

the follwing drugs will increse Calcitonin by inhepiting cyp450

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the follwing drugs will decrease Calcitonin by inhancing cyp450