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 ?
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.
Controversy and buzz swirl around eating wild Pacific salmon vs.
Many species of Pacific salmon die after spawning, and as life leaves their battered bodies, the salmon become food for a host of forest inhabitants.
Besides several species of Atlantic and Pacific salmon, American shad, steelhead, white sturgeon, and other fish are born in rivers, mature in the ocean, and then return to freshwater to spawn.
Fish Brewing shares this commitment to protecting our important water resources, so that future generations may continue to enjoy wild Pacific salmon, craft beers, and the quality of life in the Pacific Northwest," said Crayne Horton of Fish.
The acquisition of the Pinegain Group of companies, the holding company for Marr, included three factories and boosts Young's position in Pacific salmon, smoked fish and tuna.
David Morley, Agency Fisheries Officer, said: "Unlike the Pacific salmon, which only spawns once, the Atlantic salmon can return to the sea to ascend the rivers to spawn again.
They also collected samples of five wild Pacific salmon species -- Chinook, Coho, chum, pink and sockeye and analyzed the concentrations of 14 organochlorine toxins such as PCBs and dioxins in both farmed and wild salmon, Science said.
David Helvarg's "The Last Fish" (Spring '03 EIJ) is pretty accurate, but he seems to attribute the disappearance of both the Atlantic and Pacific salmon to dams.

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