Tumors vasoactive intestinal peptide-secreting

B. Indications and use Sandostatin is indicated to reduce blood levels of growth hormone and IGF-I (somatomedin-C) in acromegaly patients who have had inadequate response to or cannot be treated with surgical resection, pituitary irradiation, or bromocriptine mesylate at maximally tolerated doses. It is also indicated for the symptomatic treatment of patients with metastatic carcinoid tumors, where it suppresses or inhibits the severe diarrhea and flushing episodes associated with the disease, and for the treatment of the profuse watery diarrhea associated with VIP (vasoactive intestinal peptide)-secreting tumors (vipomas). 

Control of symptoms in patients with metastatic carcinoid (severe diarrhea and flushing episodes) and vasoactive intestinal peptide-secreting tumors (profuse water y diarrhea)... 

A powerful new synthetic peptide that mimics the action of somatostatin, octreotide acetate (Sandostatin). is approved by the Food and Drug Administration (FDA) for (he treatment of certain rare forms of intestinal endocrine cancers, such as malignant carcinoid tumors and vasoactive intestinal peptide-secreting tumors (VIPomas). Octreotide acetate is indicated for long-term treatment of severe diarrhea associated with these carcinomas. 

Octreotide is a long-acting somatostatin analog that inhibits the secretion of serotonin, vasoactive intestinal peptide, gastrin, motilin, insulin, glucagons, secretin, and pancreatic polypeptide. It is used for the control of symptoms in patients with carcinoid and vasoactive intestinal peptide-secreting tumors (VIPomas). Its major toxicity is nausea and vomiting. 

Octreotide, a synthetic octapeptide analog of endogenous somatostatin, is prescribed for the symptomatic treatment of carcinoid tumors and vasoactive intestinal peptide-secreting tumors (VIPomas). Metastatic intestinal carcinoid tumors secrete excessive... 

VF ventricular fibrillation VIPOMA type of tumor that secretes vasoactive intestinal peptide (VIP) vit vitamin... 

Originally isolated from the hypothalamus, somatostatin is a small polypeptide that is also found in neurons throughout the body, as well as in the intestine and pancreas. Somatostatin therefore predictably has a number of actions. Octreotide [awk TREE oh tide] is a synthetic octapeptide analog of somatostatin. It has a much longer half-life than the natural compound and has found use in the treatment of acromegaly caused by hormone-secreting tumors, and secretory diarrhea associated with tumors producing the vasoactive intestinal peptide (VIP). Adverse effects of octreotide treatment are flatulence, nausea, and steatorrhea. 

Secretory diarrhea occurs when a stimulating substance either increases secretion or decreases absorption of large amounts of water and electrolytes. Substances that cause excess secretion include vasoactive intestinal peptide (VIP) from a pancreatic tumor, unabsorbed dietary fat in steatorrhea, laxatives, hormones (such as secretin), bacterial toxins, and excessive bile salts. Many of these agents stimulate intracellular cyclic adenosine monophosphate and inhibit Na+/K+-ATPase, leading to increased secretion. Also, many of these mediators inhibit ion absorption simultaneously. Clinically, secretory diarrhea is recognized by large stool volumes (>1 L/ day) with normal ionic contents and osmolality approximately equal to plasma. Fasting does not alter the stool volume in these patients. 

Studies have shown that, in addition to the conventional peptide hormones of pancreatic islets (insulin, glucagon, somatostatin, and pancreatic polypeptide), these tumors can also secrete (and express) ectopic peptides, in particular gastrin and VIP (vasoactive intestinal peptide),but on occasion also ACTH (adrenal corticotropic hormone),antidiuretic hormone (ADH), MSH (melanocyte-stimulating hormone), calcitonin, neurotensin, secretoneurin, 754-356 PTH (parathyroid hormone-like peptide),growth hormone and growth hormone releasing factor, secretogranin inhibin/activin, i prohormone... 

Vasoactive intestinal peptide tumors (VIPomas)— Treatment of the profuse watery diarrhea associated with VIP-secreting tumors. Significant improvement has been noted in the overall condition of these otherwise therapeutically unresponsive patients. Therapy with octreotide results in improvement in electrolyte abnormalities (e.g., hypokalemia), often enabling reduction of fluid and electrolyte support. 

Octreotide acetate (Sandostatin) 1.02 13.6L 1.7-1.9 SC (1.0) IM (0.60-0.63) Severe diarrhea caused by carcinoid tumors or tumors secreting vasoactive intestinal peptide acromegaly... 

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