DOCSLIB.ORG

Calcitonin Salmon Nasal Spray)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Calcitonin Salmon Nasal Spray) HIGHLIGHTS OF PRESCRIBING INFORMATION delivers 200 International Units of calcitonin-salmon (3) Table 2: Risk Difference for Malignancies in Calcitonin-Salmon Treated Patients Compared with Placebo-Treated Patients PHARMACIST : DETACH HERE What are the possible side effects of Calcitonin These highlights do not include all the information needed ——————— CONTRAINDICATIONS ————————— Risk Difference1 95% Confidence Salmon Nasal Solution? Hypersensitivity to calcitonin-salmon or any of the excipients (4) Patients Malignancies 2 to use Calcitonin Salmon Nasal Solution, USP (Calcitonin (%) Interval (%) Patient Information Calcitonin Salmon Nasal Solution may cause Salmon Nasal Spray) safely and effectively. —————— WARNINGS AND PRECAUTIONS —————— All (nasal spray + oral) All 1.0 (0.3, 1.6) Excluding basal serious side effects, including: See full prescribing information for Calcitonin Salmon Nasal • Serious hypersensitivity reactions including anaphylactic shock All (nasal spray + oral) cell carcinoma 0.5 (-0.1, 1.2) Calcitonin Salmon Nasal Solution, USP Solution, USP (Calcitonin Salmon Nasal Spray). have been reported. Consider skin testing prior to treatment All (nasal spray only) All 1.4 (0.3, 2.6) • allergic reactions in patients with suspected hypersensitivity to calcitonin-salmon (Calcitonin Salmon Nasal Spray) Calcitonin Salmon Nasal Solution, USP (Calcitonin Salmon All (nasal spray only) Excluding basal 0.8 (-0.2, 1.8) Some people have had an allergic reaction when (5.1) cell carcinoma Read this Patient Information before you start using Nasal Spray), for intranasal use (Synthetic Origin) • Hypocalcemia has been reported. Ensure adequate intake of 1 The overall adjusted risk difference is the difference between the percentage using Calcitonin Salmon Nasal Solution. Some of patients who had any malignancy (or malignancy excluding basal cell Calcitonin Salmon Nasal Solution and each time Initial U.S. Approval: 1975 calcium and vitamin D (5.2) carcinoma) in calcitonin-salmon and placebo treatment groups, using the reactions may be serious and can be life threaten- ———————— RECENT MAJOR CHANGES —————— • Nasal adverse reactions, including severe ulceration can occur. Mantel-Haenszel (MH) fixed-effect method. A risk difference of 0 is suggestive you get a refill. There may be new information. This ing. Call your healthcare provider or go to the near- Periodic nasal examinations are recommended (5.3) of no difference in malignancy risks between the treatment groups. information does not take the place of talking to your Indications and Usage (1.2) 03/2014 2 The corresponding 95% confidence interval for the overall adjusted risk differ- est hospital emergency room right away if you have Warnings and Precautions (5.4) 03/2014 • Malignancy: A meta-analysis of 21 clinical trials suggests an increased risk of overall malignancies in calcitonin-salmon- ence also based on MH fixed-effect method. healthcare provider about your medical condition or any of these symptoms of an allergic reaction. ——————— INDICATIONS AND USAGE ——————— treated patients (5.4, 6.1) 6.2 Postmarketing Experience your treatment. o Calcitonin Salmon Nasal Solution is a calcitonin, indicated for Because postmarketing adverse reactions are reported voluntarily from a population of trouble breathing • Circulating antibodies to calcitonin-salmon may develop, and uncertain size, it is not always possible to reliably estimate their frequency or establish o swelling of your face, throat or tongue the treatment of postmenopausal osteoporosis in women greater may cause loss of response to treatment (5.5) a causal relationship to drug exposure. What is Calcitonin Salmon Nasal Solution? than 5 years postmenopause when alternative treatments are not o fast heartbeat The following adverse reactions have been reported during post-approval use of Calcitonin Salmon Nasal Solution is a prescription suitable. Fracture reduction efficacy has not been demonstrated. ——————— ADVERSE REACTIONS ————————— o Most common adverse reactions (3% or greater) are rhinitis, Calcitonin Salmon Nasal Solution. chest pain (1.1) medicine used to treat osteoporosis in women more o epistaxis and other nasal symptoms, back pain, arthralgia, and • Allergic/Hypersensitivity Reactions: Serious allergic reactions have been reported than 5 years after menopause. Calcitonin Salmon feel dizzy or faint Limitations of Use: headache (6) in patients receiving Calcitonin Salmon Nasal Solution, including anaphylaxis and • Due to the possible association between malignancy and cal- anaphylactic shock. Nasal Solution should be used for women who can- If you might be allergic to calcitonin-salmon, your citonin-salmon use, the need for continued therapy should be To report SUSPECTED ADVERSE REACTIONS, contact Par • Hypocalcemia: Hypocalcemia with paresthesia has been reported. Pharmaceutical at 1-800-828-9393 or FDA at 1-800-FDA-1088 • Body as a whole: facial or peripheral edema not use other treatments or who choose not to use healthcare provider should do a skin test before you re-evaluated on a periodic basis. (1.2, 5.4) • Cardiovascular: hypertension, vasodilatation, syncope, chest pain use Calcitonin Salmon Nasal Solution. • Calcitonin Salmon Nasal Solution has not been shown to or www.fda.gov/medwatch • Nervous system: dizziness, seizure, visual or hearing impairment, tinnitus other treatments for osteoporosis. increase bone mineral density in early postmenopausal women ———————— DRUG INTERACTIONS ———————— • Respiratory/Special Senses: cough, bronchospasm, dyspnea, loss of taste/smell It is not known if Calcitonin Salmon Nasal Solution • low calcium levels in your blood (hypocalcemia) (1.2) • Concomitant use of calcitonin-salmon and lithium may lead to • Skin: rash/dermatitis, pruritus, alopecia, increased sweating • Gastrointestinal: diarrhea lowers the chance of having bone fractures. Calcitonin Salmon Nasal Solution may lower the —————— DOSAGE AND ADMINISTRATION ————— a reduction in plasma lithium concentrations due to increased • Nervous system disorders: tremor urinary clearance of lithium. The dose of lithium may require calcium levels in your blood. If you have low blood • For intranasal use only: one spray (200 International Units) per 6.3 Immunogenicity Calcitonin Salmon Nasal Solution has not been day, alternating nostrils daily (2.1) adjustment (7) Consistent with the potentially immunogenic properties of medicinal products containing calcium before you start using Calcitonin Salmon • Prior to first use, allow the bottle to reach room temperature and —————— USE IN SPECIFIC POPULATIONS —————— peptides, administration of Calcitonin Salmon Nasal Solution may trigger the develop- shown to be effective in women less than 5 years Nasal Solution, it may get worse during treatment. ment of anti-calcitonin antibodies. In a two-year Calcitonin Salmon Nasal Solution clini- prime the pump (2.2) • There are no data to support use in children (8.4) cal study that evaluated immunogenicity, a measurable antibody titer was found in 69% after menopause. Your low blood calcium must be treated before you • Ensure adequate calcium and vitamin D intake (2.3) • Nasal reactions are more common in elderly patients (8.5) of patients treated with Calcitonin Salmon Nasal Solution and 3% of placebo-treated patients. Antibody formation may be associated with a loss of response to treatment It is not known if Calcitonin Salmon Nasal Solution use Calcitonin Salmon Nasal Solution. Most peo- ————— DOSAGE FORMS AND STRENGTHS ————— See 17 for PATIENT COUNSELING INFORMATION and FDA [see WARNINGS AND PRECAUTIONS (5.5)]. ple with low blood calcium levels do not have symp- Nasal Spray: 2200 International Units per mL of calcitonin-salmon approved patient labeling is safe and effective in children under 18 years of The incidence of antibody formation is highly dependent on the sensitivity and specificity toms, but some people may have symptoms. Call in a 3.7 mL fill glass bottle with screw-on pump. Each actuation Revised: 06/2016 of the assay. Additionally, the observed incidence of a positive antibody test result may age. be influenced by several factors, including assaym ethodology, sample handling, timing your healthcare provider right away if you have any of sample collection, concomitant medications, and underlying disease. For these rea- Who should not use Calcitonin Salmon Nasal of these symptoms of low blood calcium: FULL PRESCRIBING INFORMATION: CONTENTS* 6.2 Post Marketing Experience sons, comparison of antibodies to Calcitonin Salmon Nasal Solution with the incidence o 6.3 Immunogenicity of antibodies to other calcitonin-containing products may be misleading. Solution? numbness or tingling in your fingers, toes, or 1 INDICATIONS AND USAGE 7 DRUG INTERACTIONS Do not use Calcitonin Salmon Nasal Solution if you: around your mouth 010161-06 7 DRUG INTERACTIONS 1.1 Treatment of Postmenopausal Osteoporosis 8 USE IN SPECIFIC POPULATIONS 1.2 Important Limitations of Use 8.1 Pregnancy No formal drug interaction studies have been performed with Calcitonin Salmon Nasal • are allergic to calcitonin-salmon or any of the Your healthcare provider should: 2 DOSAGE AND ADMINISTRATION 8.3 Nursing Mothers Solution. ingredients in Calcitonin Salmon Nasal Solution. o 2.1 Basic Dosing Information do blood tests while you use Calcitonin Salmon 8.4 Pediatric Use Concomitant use of calcitonin-salmon and lithium may lead to a reduction in plasma 2.2 Priming (Activation) of Pump lithium concentrations due to increased urinary clearance of lithium. The dose
Load more

Recommended publications
  • Oxytocin Is an Anabolic Bone Hormone
    Oxytocin is an anabolic bone hormone Roberto Tammaa,1, Graziana Colaiannia,1, Ling-ling Zhub, Adriana DiBenedettoa, Giovanni Grecoa, Gabriella Montemurroa, Nicola Patanoa, Maurizio Strippolia, Rosaria Vergaria, Lucia Mancinia, Silvia Coluccia, Maria Granoa, Roberta Faccioa, Xuan Liub, Jianhua Lib, Sabah Usmanib, Marilyn Bacharc, Itai Babc, Katsuhiko Nishimorid, Larry J. Younge, Christoph Buettnerb, Jameel Iqbalb, Li Sunb, Mone Zaidib,2, and Alberta Zallonea,2 aDepartment of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; bThe Mount Sinai Bone Program, Mount Sinai School of Medicine, New York, NY 10029; cBone Laboratory, The Hebrew University of Jerusalem, Jerusalem 91120, Israel; dGraduate School of Agricultural Science, Tohoku University, Aoba-ku, Sendai, Miyagi 981-8555 Japan; and eCenter for Behavioral Neuroscience, Department of Psychiatry, Emory University School of Medicine, Atlanta, GA 30322 Communicated by Maria Iandolo New, Mount Sinai School of Medicine, New York, NY, February 19, 2009 (received for review October 24, 2008) We report that oxytocin (OT), a primitive neurohypophyseal hor- null mice (5). But the mice are not rendered diabetic, and serum mone, hitherto thought solely to modulate lactation and social glucose homeostasis remains unaltered (9). Thus, whereas the bonding, is a direct regulator of bone mass. Deletion of OT or the effects of OT on lactation and parturition are hormonal, actions OT receptor (Oxtr) in male or female mice causes osteoporosis that mediate appetite and social bonding are exerted centrally. resulting from reduced bone formation. Consistent with low bone The precise neural networks underlying OT’s central effects formation, OT stimulates the differentiation of osteoblasts to a remain unclear; nonetheless, one component of this network mineralizing phenotype by causing the up-regulation of BMP-2, might be the interactions between leptin- and OT-ergic neurones which in turn controls Schnurri-2 and 3, Osterix, and ATF-4 expres- in the hypothalamus (10).
    [Show full text]
  • Neuroendocrinology 165P PC125 EFFECT of CALCITONIN GENE
    Poster Communication - Neuroendocrinology 165P PC125 PC127 EFFECT OF CALCITONIN GENE-RELATED PEPTIDE ON Effects of the potent hop-derived phytoestrogen, GnRH mRNA EXPRESSION IN THE GT1-7 CELL 8-prenylnaringenin, on the reproductive neuroendocrine axis 1 1 1 2 1 J. Kinsey-Jones ,X.Li ,J.Bowe ,S.Brain and K. O’Byrne J. Bowe1,J.Kinsey-Jones1,X.Li1,S.Brain2 and K. O’Byrne1 1Division of Reproductive Health, Endocrinology and Development, 1Division of Reproductive Health, Endocrinology and Development, Kings College London, London, UK and 2Centre for Cardiovascular King’s College London, London, UK and 2Centre for Cardiovascular Biology, Kings College London, London, UK Biology, King’s College London, London, UK Calcitonin gene-related peptide (CGRP) has recently been The phytoestrogen, 8-prenylnaringenin (8-PN), is the most potent shown to induce a profound suppression of the hypothala- phytoestrogen discovered to date. Derived from hops, it is pres- mic gonadotrophin-releasing hormone (GnRH) pulse gen- ent in dietary supplements currently marketed for natural breast erator, resulting in an inhibition of pulsatile luteinising hor- enhancement, though little is known about efficacy rates or other mone (LH) secretion in the rat (Li et al., 2004). The aims of effects (Coldham & Sauer, 2001). 8-PN is also of potential inter- the present study were, (i) to determine the presence of the est in the treatment of menopausal symptoms and diseases involv- CGRP receptor subunits, receptor activity modifying protein- ing angiogenesis. It is known that various phytoestrogens pro- 1(RAMP-1) and calcitonin receptor like receptor (CL), both duce inhibitory effects on gonadotrophin secretion in both of which are required for functional activity, in the GT1-7 humans and animals (McGarvey et al, 2001).
    [Show full text]
  • Injection Safely and Effectively
    HIGHLIGHTS OF PRESCRIBING INFORMATION ---------------------DOSAGE FORMS AND STRENGTHS---------------------- These highlights do not include all the information needed to use MIACALCIN injection safely and effectively. See full prescribing Injection: 200 International Units per mL sterile solution in 2 mL multi- information for MIACALCIN injection. dose vials (3) MIACALCIN® (calcitonin-salmon) injection, synthetic, for subcutaneous ----------------------------CONTRAINDICATIONS------------------------------ or intramuscular use Hypersensitivity to calcitonin-salmon or any of the excipients (4) Initial U.S. Approval: 1975 -----------------------WARNINGS AND PRECAUTIONS------------------------ -------------------------------RECENT MAJOR CHANGES----------------------- Serious hypersensitivity reactions, including reports of fatal anaphylaxis Indications and Usage (1.4) 03/2014 have been reported. Consider skin testing prior to treatment in patients with Warnings and Precautions (5.3) 03/2014 suspected hypersensitivity to calcitonin-salmon (5.1) ----------------------------INDICATIONS AND USAGE--------------------------- Hypocalcemia has been reported. Ensure adequate intake of calcium and vitamin D (5.2) Miacalcin synthetic injection is a calcitonin, indicated for the following Malignancy: A meta-analysis of 21 clinical trials suggests an increased risk conditions: of overall malignancies in calcitonin-salmon-treated patients (5.3, 6.1) Treatment of symptomatic Paget’s disease of bone when alternative Circulating antibodies to calcitonin-salmon
    [Show full text]
  • (Calcitonin-Salmon) Nasal Spray, for Intranasal Use Vitamin D (5.2) Initial U.S
    HIGHLIGHTS OF PRESCRIBING INFORMATION -------------------------- WARNINGS AND PRECAUTIONS ----------------------­ These highlights do not include all the information needed to use • Serious hypersensitivity reactions including anaphylactic shock have been MIACALCIN nasal spray safely and effectively. See full prescribing reported. Consider skin testing prior to treatment in patients with information for MIACALCIN nasal spray. suspected hypersensitivity to calcitonin-salmon (5.1) • Hypocalcemia has been reported. Ensure adequate intake of calcium and MIACALCIN® (calcitonin-salmon) nasal spray, for intranasal use vitamin D (5.2) Initial U.S. Approval: 1975 • Nasal adverse reactions, including severe ulceration can occur. Periodic nasal examinations are recommended (5.3) • Malignancy: A meta-analysis of 21 clinical trials suggests an increased ------------------------------ INDICATIONS AND USAGE --------------------------- risk of overall malignancies in calcitonin-salmon-treated patients (5.4, Miacalcin nasal spray is a calcitonin, indicated for the treatment of 6.1) postmenopausal osteoporosis in women greater than 5 years postmenopause • Circulating antibodies to calcitonin-salmon may develop, and may cause when alternative treatments are not suitable. Fracture reduction efficacy has not loss of response to treatment (5.5) been demonstrated (1.1) ------------------------------- ADVERSE REACTIONS -------------------------------­ Limitations of Use: Most common adverse reactions (3% or greater) are rhinitis, epistaxis and other • Due to the possible association between malignancy and calcitonin­ nasal symptoms, back pain, arthralgia, and headache (6) salmon use, the need for continued therapy should be re-evaluated on a periodic basis (1.2, 5.4) To report SUSPECTED ADVERSE REACTIONS, contact Mylan • Miacalcin nasal spray has not been shown to increase bone mineral Pharmaceuticals Inc. at 1-877-446-3679 (1-877-4-INFO-RX) or FDA at 1­ density in early postmenopausal women (1.2) 800-FDA-1088 or www.fda.gov/medwatch.
    [Show full text]
  • Transition from Biological to Chemical Assay for Quality Assurance of Medicinal Substances (Apis) and Formulated Preparations
    WHO/BS/07.2070 ENGLISH ONLY EXPERT COMMITTEE ON BIOLOGICAL STANDARDIZATION Geneva - 8 to 12 October 2007 Discussion paper: Transition from biological to chemical assay for quality assurance of medicinal substances (APIs) and formulated preparations A Bristow National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Potters Bar, Herts EN6 3QG, UK ML Rabouhans, J Joung, DJ Wood World Health Organization, Geneva, Switzerland © World Health Organization 2007 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected] ). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected] ). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
    [Show full text]
  • The Role of Corticotropin-Releasing Hormone at Peripheral Nociceptors: Implications for Pain Modulation
    biomedicines Review The Role of Corticotropin-Releasing Hormone at Peripheral Nociceptors: Implications for Pain Modulation Haiyan Zheng 1, Ji Yeon Lim 1, Jae Young Seong 1 and Sun Wook Hwang 1,2,* 1 Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 02841, Korea; [email protected] (H.Z.); [email protected] (J.Y.L.); [email protected] (J.Y.S.) 2 Department of Physiology, College of Medicine, Korea University, Seoul 02841, Korea * Correspondence: [email protected]; Tel.: +82-2-2286-1204; Fax: +82-2-925-5492 Received: 12 November 2020; Accepted: 15 December 2020; Published: 17 December 2020 Abstract: Peripheral nociceptors and their synaptic partners utilize neuropeptides for signal transmission. Such communication tunes the excitatory and inhibitory function of nociceptor-based circuits, eventually contributing to pain modulation. Corticotropin-releasing hormone (CRH) is the initiator hormone for the conventional hypothalamic-pituitary-adrenal axis, preparing our body for stress insults. Although knowledge of the expression and functional profiles of CRH and its receptors and the outcomes of their interactions has been actively accumulating for many brain regions, those for nociceptors are still under gradual investigation. Currently, based on the evidence of their expressions in nociceptors and their neighboring components, several hypotheses for possible pain modulations are emerging. Here we overview the historical attention to CRH and its receptors on the peripheral nociception and the recent increases in information regarding their roles in tuning pain signals. We also briefly contemplate the possibility that the stress-response paradigm can be locally intrapolated into intercellular communication that is driven by nociceptor neurons.
    [Show full text]
  • Somatostatin Acts Via a Pertussis Toxin-Sensitive Mechanism on Calcitonin Secretion in C-Cells
    Henry Ford Hospital Medical Journal Volume 40 Number 3 Article 35 9-1992 Somatostatin Acts Via a Pertussis Toxin-Sensitive Mechanism on Calcitonin Secretion in C-Cells Angela Zink Hans Scherubl Friedhelm Raue Reinhard Ziegler Follow this and additional works at: https://scholarlycommons.henryford.com/hfhmedjournal Part of the Life Sciences Commons, Medical Specialties Commons, and the Public Health Commons Recommended Citation Zink, Angela; Scherubl, Hans; Raue, Friedhelm; and Ziegler, Reinhard (1992) "Somatostatin Acts Via a Pertussis Toxin-Sensitive Mechanism on Calcitonin Secretion in C-Cells," Henry Ford Hospital Medical Journal : Vol. 40 : No. 3 , 289-292. Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol40/iss3/35 This Article is brought to you for free and open access by Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Henry Ford Hospital Medical Journal by an authorized editor of Henry Ford Health System Scholarly Commons. Somatostatin Acts Via a Pertussis Toxin-Sensitive Mechanism on Calcitonin Secretion in C-Cells Angela Zink,* Hans Scherubl,^ Friedhelm Raue,* and Reinhard Ziegler' The effect ofthe somatostatin analog octreotide on cAMP-mediated calcitonin (CT) secretion and cAMP accumulation in C-cells was investigated. Glucagon stimulated cAMP accumulation and CT secretion with a maximal eff'ecl at a concentration oflQ-^M. The cAMP antagonist RpcAMPs blocked the glucagon-induced CT secretion down to control levels. Therefore, no other second messengers seem to he involved in glucagon-stimulated CT secretion. Octreotide in increasing doses (70'' to 10'^ M) inhibited cAMP accumulation and CT secretion with a maximal effect at a concentration of 10'^ (40% and 29% of control values, respectively).
    [Show full text]
  • Co-Secretion of Calcitonin Gene-Related Peptide, Gastrin
    Postgraduate Medical Journal (1987) 63, 123-130 Postgrad Med J: first published as 10.1136/pgmj.63.736.123 on 1 February 1987. Downloaded from Co-secretion ofcalcitonin gene-related peptide, gastrin- releasing peptide and ACTH by a carcinoid tumour metastasizing to the cerebellum M.A. Ghatei, M.R. Stratton', J.M. Allen, G.F. Joplin, J.M. Polak2 and S.R. Bloom Departments ofMedicine, 'Histopathology and 2Histochemistry, Hammersmith Hospital, Royal Postgraduate Medical School, London W12 OHS, UK. Summary: A carcinoid tumour presenting as Cushing's syndrome is reported. Although no tumour mass could be initially identified the patient returned with first a liver and subsequently a cerebellar mass both of which were resected. Only at post-mortem was the lung primary discovered. ACTH, gastrin- releasing peptide (GRP) and calcitonin gene-related peptide were elevated in plasma before resection of the hepatic tumour. These peptides were demonstrated in both the hepatic and cerebellar tumours by immunocytochemistry and radioimmunoassay. This case illustrates the occasional tendency of primary lung carcinoids to remain small and clinically undetectable while generating secondary tumours which are symptomatic. It is suggested that immunological demonstration of GRP may be diagnostically helpful in Protected by copyright. directing attention to the lung as a primary site in neuroendocrine tumours which present in this fashion. Introduction Gastrin-releasing peptide (GRP), a peptide of 27 ACTH secretion syndrome resulting from a metastatic amino acid residues,' and its C-terminal decapeptide2'3 carcinoid tumour of pulmonary origin, which was (neuromedin C), are now considered to be the mam- found in addition to contain and secrete three forms of malian forms of bombesin.4 Both amphibian bom- gastrin-releasing peptide (bombesin) and CGRP.
    [Show full text]
  • Diagnostic and Therapeutic Implications of Ectopic Hormone Production in Small Cell Carcinoma of the Lung
    Thorax: first published as 10.1136/thx.35.2.101 on 1 February 1980. Downloaded from Thorax, 1980, 35, 101-106 Diagnostic and therapeutic implications of ectopic hormone production in small cell carcinoma of the lung MOGENS HANSEN, MOGENS HAMMER, AND LOTTE HUMMER From the Department of Chemotherapy R II-R V, Finsen Institute, and Department of Internal Medicine C, Bispebjerg Hospital, and the Departments of Nephrology P and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark ABSTRACT In 75 unselected and untreated patients with small cell carcinoma of the lung, plasma ACTH, serum calcitonin, and antidiuretic hormone (ADH) in plasma and urine were related to corresponding clinical symptoms and biochemical findings at the time of diagnosis. The sig- nificance of elevated concentrations of these substances in relation to treatment was also in- vestigated. Plasma ACTH concentrations were increased in 22 patients (29%), and 25 patients (33%) were considered to have inappropriate ADH secretion. Only one patient had definite hypokalaemic alkalosis, and one patient pronounced hyponatraemia, with associated clinical syndromes of ectopic ACTH and ADH secretion. Serum calcitonin concentrations were in- copyright. creased in 48 patients (65%). No related clinical symptoms were disclosed, and all these patients had normal serum calcium concentrations. Thirty-three of 66 patients (50%) had raised levels of free cortisol in a 24-hour urine and these levels were significantly related to plasma ACTH con- centrations. The median survival was slightly shorter in patients with increased values of the three substances, but this was not related to increased plasma ACTH concentrations and was not http://thorax.bmj.com/ statistically significant.
    [Show full text]
  • Self Quiz - Endocrine System Pro: Manhal Chbat,MD
    Self Quiz - Endocrine System Pro: Manhal Chbat,MD 1. Which of the following is true of the endocrine system but not the nervous system? A) directs long term processes such as pregnancy and puberty B) communicates via chemical signals C) regulates activities of muscles and glands D) A and B are correct. E) A, B and C are correct. 2. Which of the following statements about the endocrine system is NOT correct? A) It uses hormones, which are transported by the blood, to communicate with distant tissues. B) Its hormones must bind to specific receptor sites in order to have effects on a tissue. C) It targets are limited to muscles, glands and nerves. D) It may take seconds, hours, or days to respond to a stimulus. E) Its actions may last seconds, hours, or days. 3. The anterior pituitary gland responds to gonadotropin releasing hormone (GnRH), but the posterior pituitary gland does not. Why? A) Only anterior pituitary gland is permeable to GnRH. B) Only the anterior pituitary gland is vascular. C) Only the anterior pituitary gland is connected by neurons to the hypothalamus. D) Only the anterior pituitary gland is connected to a duct carrying GnRH. E) Only the anterior pituitary gland has receptors for GnRH. 4. Each of the following is a lipid-soluble hormone EXCEPT: A) aldosterone B) thyroid hormone C) insulin D) nitric oxide E) cortisone 5. Which of the following classes of hormones is water-soluble? A) eicosanoids B) amines C) peptides D) proteins E) All of these are correct. 6. What do T3 and T4 have in common with epinephrine and norepinephrine? A) They are all water-soluble.
    [Show full text]
  • The Proopiomelanocortin Gene
    56:4 A J L CLARK The POMC gene 56:4 T27–T37 Thematic Review 60 YEARS OF POMC The proopiomelanocortin gene: discovery, deletion and disease Correspondence should be addressed to Adrian J L Clark A J L Clark Centre for Endocrinology, William Harvey Research Institute, Queen Mary University of London, Email Charterhouse Square, London, UK [email protected] Abstract The cloning of the bovine proopiomelanocortin (POMC) cDNA in 1978 by Nakanishi Key Words and colleagues was the result of a remarkable series of exacting and ingenious f proopiomelanocortin experiments. With this work, they instantly confirmed the single precursor hypothesis f adrenocorticotrophin for adrenocorticotrophic hormone-β-lipotropin, as it was then known, and in so f adrenal doing revealed the existence of additional, largely unpredicted, N-terminal peptides f obesity that together formed the POMC precursor peptide. This work paved the way for a f genetic disease host of additional studies into the physiology of these peptides and their regulation. Furthermore, the cloning of the murine Pomc gene was essential for subsequent studies, in which Pomc was intentionally deleted in the mouse illuminating its substantial role in body weight regulation and adrenal function. Contemporaneously with this work, naturally occurring mutations in human POMC came to light underlining the vital role of this gene in appetite regulation. This article reviews each of these aspects of POMC with the benefit of several decades of hindsight and informed by more recent genomic and Journal of Molecular Journal of Molecular Endocrinology transcriptomic data. Endocrinology (2016) 56, T27–T37 Introduction The concept that one precursor peptide, adrenocortico­ had become reasonably well established, this undertaking trophic hormone­β­lipotropin (ACTH­β­LPH), could remained a significant challenge.
    [Show full text]
  • Eel Calcitonin on Gastric Somatostatin and Gastrin Release
    Gut: first published as 10.1136/gut.21.2.94 on 1 February 1980. Downloaded from Gut, 1980, 21, 94-97 Effects of [Asu'7]-eel calcitonin on gastric somatostatin and gastrin release T CHIBA, T TAMINATO. S KADOWAKI, Y GOTO, K MORI, Y SEINO, H ABE, K CHIHARA, S MATSUKURA, T FUJITA, AND T KONDO From the Third Division, Department of Medicine, Kobe University School of Medicine, Kobe, and Uwajima City Hospital, Ehime, Japan SUMMARY Effects of [Asul17]-eel calcitonin on gastric somatostatin and gastrin secretion were studied by using the isolated perfused rat stomach. [Asul 7]-eel calcitonin (10-9 -10-7M) caused a simultaneous dose-dependent increase of gastric somatostatin release and decrease of gastrin secretion, with a significant correlation between these two. The demonstration of calcitonin stimula- tion of gastric somatostatin release raises the possibility of somatostatin-mediated suppression of gastrin secretion by calcitonin. In addition to its effects on bone and kidney as a of Lefebvre et al.'s with minor modifications.'4 hypocalcaemic agent, calcitonin was found to Animals were anaesthetised with pentobarbital suppress various gastrointestinal functions,1-5 in- (40 mg/kg) after an overnight fast. After a midline cluding secretion of gastrin and gastric acid.6,8 laparotomy, polyethylene cannulae were inserted Recently, significant amounts of somatostatin, a into the left gastric artery and gastric vein. All other potent inhibitor of gastric acid and gastrin secre- vessels and pancreas were carefully excluded by http://gut.bmj.com/ tion," 10 were demonstrated in the stomach by radio- ligation. After cardial ligation, a catheter was in- immunoassayll 12 as well as by immunocyto- serted into the stomach through the pyloric ring to chemical technique.'3 More recently, we demon- drain gastric juice.
    [Show full text]