Octreotide

Prospective, randomized trial did not show a benefit after pancreas transplantation. Octreotide lowers cyclosporine-A levels and may cause escape rejection if cyclosporine levels are not carefully monitored. Intravenous infusions of 25-50 mcg/hour have been utilized. 

Restlessness, drowsiness, fatigue, lassitude, insomnia, headache, confusion, dizziness, mental depression Extrapyrainidal Reactions Acute dystonic reactions. Parkinsonian-like symptoms Endocrine Disturbances 

Galactorrhea, amenorrhea, gynecomastia, impotence seconder y to hyperprolactinemia, fluid retention seconder y to transient elevation of aldosterone 

Nausea and Vomiting Associated with Cancer Chemotherapy 

15 minutes, 30 minutes before beginning chemotherapy and repeated every 2 hours for 2 doses and then ever y 3 hours for 3 doses 

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Indium-111. Kits for labeling using other radionucHdes include two indium-111 compounds. Indium-111 pentetreotide is used for the scintigraphic localization of primary and metastatic neuroendocrine tumors bearing somatostatin receptors. For octreotide DTP A, the active agent is suppHed in a lyopbilized kit with gentisic acid, citrate buffer, and inositol. 

USP (Leupton) octreotide ace-tate [79517-01 ] 2H4O2 049 -66 1oOloS2 1019.24 (65) mestastatic carciuoid effects nausea diarrhea loose... 

Octreotide (SMS201-995) Binding to sst2 with high affinity, slightly lower affinity to sst5 and sst3... 

Can use octreotide in combination with phenylephrine in patients without enteral access... 

Octreotide is a synthetic analogue of somatostatin it selectively causes vasoconstriction of the splanchnic bed, decreasing portal venous pressure with few serious side effects. Vasopressin has been used, but since it causes non-selective vasoconstriction, it carries the risk of systemic consequences,... 

TSH 0.S-2.S milliunits/L (0.5-2.5 microunits/mL)a Gold standard may be lowered by dopamine, dopamine agonists, glucocorticoids, octreotide, recovery from severe nonthyroidal illness... 

Octreotide Long-acting 300-1200 mcg/day Injection site pain, Most useful in Nelson s syndrome... 

Use of the first-generation somatostatin analog octreotide is limited by its extremely short duration of action and requirement for subcutaneous administration at least three times a day. If a patient s GH level returns to baseline before the end of an 8-hour dosing interval, the frequency of octreotide administration can be increased to every 4 to 6 hours. Most patients require octreotide in doses of 100 to 200 meg three times daily.19,20 To improve patient tolerance to gastrointestinal (GI) adverse effects, start octreotide at 50 meg every 8 hours.20 Assess IGF-I serum concentrations every 2 weeks after initiating therapy to further titrate dose in increments of 50 meg per dose. 

Diarrhea may occur from effects of chemotherapy on the lower portion of the GI tract. Diarrhea can be severe and may need to be treated with intravenous fluids and electrolytes. Infectious causes, such as C. difficile, should be ruled out. Pharmacologic therapy of diarrhea can range from loperamide or cholestyramine to octreotide for severe cases of diarrhea that are refractory to usual treatments. 

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