NCLEX pharmacology review on osteoporosis and the medication Calcitonin (Fortical or Miacalcin).

This NCLEX pharmacology practice question will test your nursing knowledge about the adverse effects of the medication Calcitonin. To answer this question correctly, you must know the mechanism of action of Calcitonin and what type of signs and symptoms may present in a patient who is experiencing an adverse reaction from this drug.

What is Calcitonin? It is secreted by the thyroid gland to maintain normal calcium levels. If calcium levels are too high, Calcitonin will be secreted. This will decrease osteoCLAST activity and cause the kidneys to excrete calcium out into the urine.

What do osteoCLASTS do? They consume bone within the spongy bone matrix to help increase the calcium levels. This is prescribed in the treatment of osteoporosis to help slow down their activity and allow the osteoBLASTS to build up bone, which will make bones stronger overtime.

Due to the nature of how this drug works, the patient may experience hypocalcemia. Therefore, the nurse should monitor the patient for these signs and symptoms.

Carpopedal spams is very significant in this scenario. This is known as Trousseau's sign, and this will happen when there is occlusion on the upper arm (brachial artery), like with a blood pressure cuff. If calcium levels are lower enough, the wrist will start to involuntary flex at the wrist and adduction of the thumb and extension of the phalangeals will occur.

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