salmon

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calcitonin (salmon)

APO-Calcitonin, Calcimar, Caltine, Fortical, Miacalcic (UK), Miacalcin, Miacalcin Nasal Spray, Sandoz Calcitonin

Pharmacologic class: Hormone (calcium-lowering)

Therapeutic class: Hypocalcemic

Pregnancy risk category C

Action

Directly affects bone, kidney, and GI tract. Decreases osteoclastic osteolysis in bone; also reduces mineral release and collagen breakdown in bone and promotes renal excretion of calcium. In pain relief, acts through prostaglandin inhibition, pain threshold modification, or beta-endorphin stimulation.

Availability

Injection: 0.5 mg/ml (human), 1 mg/ml (human), 200 international units/ml in 2-ml vials (salmon)

Nasal spray (salmon): 200 international units/actuation, metered nasal spray in 3.7 ml-bottle

Indications and dosages

Postmenopausal osteoporosis

Adults:Calcitonin (salmon)-100 international units/day I.M. or subcutaneously, or 200 international units/day intranasally with concurrent supplemental calcium and vitamin D

Paget's disease of bone (osteitis deformans)

Adults:Calcitonin (salmon)-Initially, 100 international units/day I.M. or subcutaneously; after titration, maintenance dosage is 50 to 100 international units daily or every other day (three times weekly). Calcitonin (human)-0.5 mg I.M. or subcutaneously daily, reduced to 0.25 mg daily.

Hypercalcemia

Adults:Calcitonin (salmon)-4 international units/kg I.M. or subcutaneously q 12 hours; after 1 or 2 days, may increase to 8 international units/kg q 12 hours; after 2 more days, may increase further, if needed, to 8 international units q 6 hours.

Contraindications

• Hypersensitivity to drug or salmon
• Pregnancy or breastfeeding

Precautions

Use cautiously in:
• renal insufficiency, pernicious anemia
• children.

Administration

Before salmon calcitonin therapy begins, perform skin test, if prescribed. Don't give drug if patient has positive reaction. Have epinephrine available.
• Bring nasal spray to room temperature before using.
• Give intranasal dose as one spray in one nostril daily; alternate nostrils every day.
• To minimize adverse effects, give at bedtime.
• Rotate injection sites to decrease inflammatory reactions.

Adverse reactions

CNS: headache, weakness, dizziness, paresthesia

CV: chest pain

EENT: epistaxis, nasal irritation, rhinitis

GI: nausea, vomiting, diarrhea, epigastric pain or discomfort

GU: urinary frequency

Musculoskeletal: arthralgia, back pain

Respiratory: dyspnea

Skin: rash

Other: altered taste, allergic reactions including facial flushing, swelling, and anaphylaxis

Interactions

Drug-drug.Previous use of bisphosphonates (alendronate, etidronate, pamidronate, risedronate): decreased response to calcitonin

Patient monitoring

• Monitor for adverse reactions during first few days of therapy.
• Assess alkaline phosphatase level and 24-hour urinary excretion of hydroxyproline.
• Check urine for casts.
• Monitor serum electrolyte and calcium levels.

Patient teaching

• Instruct patient to take drug before bedtime to lessen GI upset. Tell him to call prescriber if he can't maintain his usual diet because of GI upset.
• Inform patient using nasal spray that runny nose, sneezing, and nasal irritation may occur during first several days as he adjusts to spray.
• Instruct patient to bring nasal spray to room temperature before using.
• Advise patient to blow nose before using spray, to take intranasal dose as one spray in one nostril daily, and to alternate nostrils with each dose.
• Tell patient to discard unrefrigerated bottles of calcitonin (salmon) nasal spray after 30 days.
• Encourage patient to consume a diet rich in calcium and vitamin D.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.

Relating to mucocutaneous lesions with a ‘salmon’ colour

salmon

farmed finfish; many species in the genera Salmo and Oncorhyncus.

salmon louse
Lepeophtherius salmonis.
salmon poisoning, salmon disease
a disease of dogs and other canids which eat salmon from streams in the Pacific Northwest of the USA, and caused by neorickettsia helminthoeca. The infection is transmitted by the fluke, Nanophyetus salmincola, parasitic in the salmon. The disease in dogs is characterized by fever, ocular discharge and edema of the eyelids, followed by vomiting, then diarrhea and later severe dysentery and death in untreated cases. See also elokomin fluke fever.
References in periodicals archive ?
Designed specifically to raise Pacific salmon, steelhead and brown trout, the Salmon River Hatchery became the crown jewel of the system: a modern facility able to produce all of the introduced salmonids needed to create what has become a world-class multi-million dollar sport fishery in Lakes Ontario and Erie.
Special report of the GSI steering committee and the Pacific Salmon Commission's committee on scientific cooperation.
Of the 81 samples for which we had interpretable sequence data, 11 (14%) were labeled as wild Pacific salmon but proved to be Atlantic salmon (Figure 3).
Approximately half of the wild Pacific salmon sold in Japan are caught in the coastal areas of northern Japan, and the other half are imported from Far East Russia and the Pacific coast of North America.
A recent report of the Independent Science Advisory Board of the Northwest Power and Conservation Council details the complex structure and processes of harvest management for Pacific salmon.
The current interest in Pacific salmon in Canadian western Arctic waters is due largely to the belief that a perceived increase in their abundance is a confirmation of climate change.
Controversy and buzz swirl around eating wild Pacific salmon vs.
In their article, "Risk-Based Consumption Advice for Farmed Atlantic and Wild Pacific Salmon Contaminated with Dioxins and Dioxin-like Compounds," Foran et al.
Presenting accurate information about the life cycle of the wild Pacific salmon in the format of a beautifully illustrated picturebook, young readers age 4 to 8 will enjoy author Annette LeBox's eloquent and enthusiastically recommended story of Sumi, a coho salmon from her birth and trip down river to the ocean, to her time as a fully mature fish swimming in the great seas, to her determined return up river to her birthplace where she can spawn.
The story unfolded when the limes realized that many of the stores were selling "fresh" wild Pacific salmon in the fish's off-season.
A three-ounce vacuum-sealed, ready-to-serve pouch of Chicken of the Sea Smoked Pacific Salmon retails for a suggested $2.

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