์ฐ์ด ์นผ์ํ ๋
์ฐ์ด ์นผ์ํ ๋์ ํฉ์ฑ ํด๋ฆฌํฉํ์ด๋ ํธ๋ฅด๋ชฌ์ผ๋ก, ์์ํ์์๋ ์ฃผ๋ก ์ฌ๊ฐํ **๊ณ ์นผ์ํ์ฆ**(์: ์ฝ๋ ์นผ์ํ๋กค ์ฅ์ฝ ์ค๋ , ๋ํ์ ํญ๋ฌธ๋ญ์ ์ ๋๋ ๋ฆผํ์ข ์ผ๋ก ์ธํ ๊ณ ์นผ์ํ์ฆ) ๋ฐ ํ์ถฉ๋ฅ์ ์์์ฑ ์ด์ฐจ์ฑ ๋ถ๊ฐ์์ ๊ธฐ๋ฅ ํญ์ง์ฆ(NSHP)์ ์กฐ์ ํ๋ ๋ฐ ์ฌ์ฉ๋ฉ๋๋ค. ๋ํ ์ฌํ ๊ณจํต์ฆ์ ๋ณด์กฐ ์น๋ฃ์ ๋ก ์ฌ์ฉ๋ ์๋ ์์ต๋๋ค. * **์์ ์์ **: ์ฐ์ด ์นผ์ํ ๋์ ํฌ์ ๋ฅ(์ธ๊ฐ) ์นผ์ํ ๋๋ณด๋ค ์ฝ 50๋ฐฐ ๋ ๊ฐ๋ ฅํ๊ณ ์์ฉ ์๊ฐ์ด ๊ธธ์ด ์น๋ฃ์ ์ ํธ๋ฉ๋๋ค. * **ํ๊ณ์ **: ๋น์ฉ์ด ๋น์ธ๊ณ **ํํคํ๋ฝ์์ค(๊ธ์ฑ ๋ด์ฑ)**(์์ฉ์ฒด ํํฅ ์กฐ์ )๊ฐ ๋น ๋ฅด๊ฒ ๋ฐ์ํ์ฌ, ๋ฉฐ์น ์ฐ์ ์ฌ์ฉ ํ์๋ ํจ๊ณผ๊ฐ ๋จ์ด์ง๋ ๊ฒฝ์ฐ๊ฐ ๋ง์ ์์์ ์ ์ฉ์ฑ์ ์ ํ์ด ์์ต๋๋ค. * **์ฃผ์**: ์นผ์ํ ๋(ํ์ฒญ ์นผ์ ์ ํ)๊ณผ ์นผ์ํธ๋ฆฌ์ฌ(ํ์ฒญ ์นผ์ ์์น)์ ํผ๋ํ์ง ๋ง์ญ์์ค.
์์ฉ ๊ธฐ์ : Calcitonin exerts a multitude of physiologic effects to rapidly lower serum calcium levels: * **Bone**: Binds directly to **calcitonin receptors** on osteoclasts โ profoundly inhibits osteoclastic bone resorption โ decreases the release of calcium and phosphorus from bone into the extracellular fluid. * **Kidneys**: Acts on the renal tubules โ reduces tubular reabsorption of calcium, phosphate, sodium, magnesium, potassium, and chloride โ promotes their renal excretion. * **Gastrointestinal Tract**: Increases jejunal secretion of water, sodium, potassium, and chloride (but notably not calcium).
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Hypervitaminosis D (toxicity)/hypercalcemia ยท 4-8 Units/kg ยท SC ยท two to three times a day ยท Effects are short-lived and multiple treatments are required.
- Hypervitaminosis D (toxicity)/hypercalcemia ยท 4-6 Units/kg ยท SC ยท q2-3 hours ยท until serum calcium levels are normalized
- Adjunctive therapy if fluid deficit replacement, saline diuresis, furosemide and prednisone have failed to control calcium ยท 4 Units/kg IV, then 4-8 Units/kg SC ยท IV, then SC ยท q12-24h
- Hypervitaminosis D (toxicity)/hypercalcemia ยท 4-6 Units/kg ยท SC ยท q8-12h
- Hypercalcemia (Green iguanas) ยท 1.5 Units/kg ยท SC ยท q8h ยท for several weeks if necessary ยท In combination with fluid therapy
- Nutritional secondary hyperparathyroidism (NSHP) ยท 50 Units/kg ยท IM ยท once weekly ยท for 2-3 doses ยท Use if reptile is not hypocalcemic.
- Nutritional secondary hyperparathyroidism (NSHP) ยท 50 Units/kg ยท IM ยท weekly ยท for 2-3 doses ยท Correct husbandry problems and correct hypocalcemia with calcium and vitamin D first. Once calcium level is normal and patient is on oral calcium supplementation (usually about 7 days after starting therapy) give calcitonin. Supportive care can be tapered off once patient becomes stable.
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Hypersensitivity to calcitonin
- Patients with a history of hypersensitivity to other proteins may be at risk
์ด์๋ฐ์
- Anorexia
- Vomiting
- Hypocalcemia (with overmedication)
- Diarrhea
- Injection site pain and swelling
- Redness
- Peripheral paresthesias (reported in humans)
- Allergic reactions (rare)
- Tachyphylaxis (resistance to therapy over time)
์ฝ๋ฌผ ์ํธ์์ฉ
- Vitamin D analogs ยท May interfere with the efficacy of calcitonin
- Calcium products ยท May interfere with the efficacy of calcitonin
๋ชจ๋ํฐ๋ง
- Serum Calcium
๊ณผ์ฉ๋
Very limited data is available. Nausea and vomiting have been reported after accidental overdose injections. Chronic overdosing can lead to severe **hypocalcemia**.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.