Look inside the book: Nursing 2025-2026 Drug Handbook

208 calcitonin salmon

PATIENT TEACHING Alert: Stress importance of maintaining viral suppression by adhering to medication regimen and scheduled visits. Tell patient to contact prescriber if patient plans to or misses a scheduled injection, and explain that oral therapy may be used to replace up to two con secutive monthly injections. • Inform patient that injection-site reactions (pain, erythema, tenderness, pruritus, lo cal swelling) and systemic reactions (fever, pain [musculoskeletal pain, sciatica]) may occur. • Teach patient to immediately report signs and symptoms of hypersensitivity reaction. • Advise patient of the need for lab tests to monitor liver function. • Tell patient to immediately report depres sive symptoms (depressed mood, depres sion, major depression, altered mood, mood swings, feeling tense, negative thoughts, sui cidality). • Advise patient that if drug is stopped, other medicine will be given to treat HIV-1 infec tion. • Warn patient of reproductive potential about the long duration of drug exposure; explain that drug’s effect in pregnancy is still under study.

impairment hasn’t been studied. Use cau tiously and monitor for adverse effects. • Residual levels of cabotegravir and rilpivirine may remain in systemic circulation for 12 months or longer. • Use only in patients who agree to required injections because nonadherence to injections or missed doses could lead to viral resistance. To minimize risk of viral resistance, initiate an alternative, suppressive antiretroviral reg imen no later than when injection is due. If virologic failure is suspected, switch patient to an alternative regimen as soon as possible. • Safety and effectiveness in children younger than age 12 or weighing less than 35 kg haven’t been established. • Use cautiously in older adults. • Dialyzable drug: No. PREGNANCY-LACTATION-REPRODUCTION • It isn’t known if drug increases risk of birth defects or miscarriage. Consider benefits and risks when using in patients of childbearing potential or during pregnancy. • Enroll patients exposed to drug during pregnancy in the Antiretroviral Pregnancy Registry (1-800-258-4263). • It isn’t known if drug appears in human milk or how drug affects milk production or infants who are breastfed. Patients with HIV-1 infection shouldn’t breastfeed to avoid trans mission to infant. NURSING CONSIDERATIONS • Follow injection instructions carefully to avoid accidental IV administration. • Monitor patient for about 10 minutes af ter injection. If postinjection reaction oc curs (dyspnea, agitation, abdominal cramp ing, flushing, sweating, oral numbness, and changes in BP), treat as indicated. • Monitor for signs and symptoms of hyper sensitivity (severe rash, rash accompanied by fever, general malaise, fatigue, muscle or joint aches, blisters, mucosal involvement [oral blisters or lesions], conjunctivitis, facial edema, hepatitis, eosinophilia, angioedema, difficulty breathing, dark urine); if any occur, immediately discontinue drug and treat pa tient as appropriate. • Routinely monitor LFT values and discon tinue drug for suspected liver toxicity. • Monitor patient with depressive symptoms to assess whether symptoms are related to drug and to determine risk of continued therapy.

calcitonin salmon kal-si-TOE-nin

Miacalcin Therapeutic class: Antiosteoporotics Pharmacologic class: Polypeptide hormones AVAILABLE FORMS Injection: 200 units/mL in 2-mL vials Nasal spray: 200 units/activation INDICATIONS & DOSAGES ➤ Paget disease of bone (osteitis deformans) Adults: 100 units daily IM or subcut. ➤ Hypercalcemia

Adults: 4 units/kg every 12 hours IM or sub cut. If response is inadequate after 1 or 2 days, increase dosage to 8 units/kg every 12 hours. If response remains unsatisfactory after 2 ad ditional days, increase dosage to maximum of 8 units/kg every 6 hours.

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Reactions in bold italics are life-threatening .