Look inside the book: Nursing 2025-2026 Drug Handbook

calcitonin salmon 209

➤ Postmenopausal osteoporosis in patients more than 5 years after menopause Adults: 200 units (one activation) daily in tranasally, alternating nostrils daily. Or, 100 units IM or subcut daily. Patient should receive adequate vitamin D and calcium sup plements (at least 1,000 mg elemental cal cium and 400 units of vitamin D) daily. ADMINISTRATION IM • IM route is preferred if volume of dose ex ceeds 2 mL; use multiple injection sites. • Visually inspect solution for particles, cloudi ness, or discoloration. If present, discard. • Store in refrigerator between 36 ◦ and46 ◦ F (2 ◦ and8 ◦ C). Intranasal • Alternate nostrils daily. • Allow bottle to reach room temperature and prime pump before first use by releasing until a full spray is produced. Don’t prime pump every day. Don’t shake bottle. • Carefully insert nozzle into nostril with pa tient’s head upright and firmly depress pump toward bottle. • Wipe nozzle with a clean, damp cloth and dry. • Discard spray container after 14 doses (2 mL bottle) or 30 doses (3.7 mL bottle). • Keep bottle refrigerated between 36 ◦ and 46 ◦ F(2 ◦ and8 ◦ C) while unopened; store in an upright position at room temperature after opening. Subcutaneous • Visually inspect solution for particles, cloudiness, or discoloration. If present, discard. • Alternate injection sites. • Store in refrigerator between 36 ◦ and46 ◦ F (2 ◦ and8 ◦ C). ACTION Decreases osteoclastic activity by inhibiting osteocytic osteolysis; decreases mineral re lease and matrix or collagen breakdown in bone. Route Onset Peak Duration IM, subcut 2 hr 23min 6–8 hr Intranasal Rapid 10–13 min Unknown Half-life: IM and subcut, 58 to 64 minutes. intranasal, 18 minutes. ADVERSE REACTIONS CNS: depression, headache, dizziness, paresthesia, fatigue. CV: flushing, pedal edema. EENT: eye pain, abnormal tearing,

conjunctivitis, epistaxis, nasal congestion, rhinitis, sinusitis, facial edema. GI: tran sient nausea, salty taste, anorexia, nausea, abdominal pain. GU: increased urinary fre quency, nocturia. Hematologic: infection, lymphadenopathy. Musculoskeletal: arthro sis, myalgia, back pain, osteoarthritis. Res piratory: bronchospasm, URI, shortness of breath, sinusitis. Skin: rash, pruritus of ear lobes, injection-site reaction. Other: hy persensitivity reactions, flulike symptoms, malignancy. INTERACTIONS Drug-drug. Lithium: May reduce plasma lithium level due to increased urinary clear ance of lithium. Monitor level and adjust lithium dosage as needed. Zoledronic acid: May enhance hypocalcemic effect of zoledronic acid. Monitor therapy. EFFECTS ON LAB TEST RESULTS • May reduce calcium level. • May increase urine sediment. CONTRAINDICATIONS & CAUTIONS • Contraindicated in patients hypersensitive to drug or any of its components. • For Paget disease or osteoporosis, reserve use for patients with contraindications or in tolerance to alternative agents. • Safety and effectiveness in children haven’t been established. • Dialyzable drug: Unknown. • H Overdose S&S: Hypocalcemic tetany (in creased neuromuscular irritability, repeti tive neuromuscular movements after a single stimulus). PREGNANCY-LACTATION-REPRODUCTION • Use during pregnancy only if potential ben efit justifies fetal risk. • Nasal spray isn’t indicated for use in patients of childbearing potential. • It isn’t known if drug appears in human milk, but it has been shown to decrease milk production in animals. Before use during breastfeeding, consider risk of infant expo sure, benefits of breastfeeding to infant, and benefits of treatment to patient. NURSING CONSIDERATIONS

C

Copyright © 2025 Wolters Kluwer, Inc. Unauthorized reproduction of this content is prohibited. • Skin testing is usually done before therapy in patient with suspected drug sensitivity.

Canada

OTC

Off-label use

Do not crush

*Liquid contains alcohol

Genetic