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Sunday, 14 February 2016

Octreotide : Commonly used drugs in Emergency & ICU





Octreotide 

Trade names: Sandostatin
Class: Antidiarrheals, hormones
Pregnancy: (Category B) Action:
§   Suppresses secretion of serotonin and gastroenterohepatic peptides
§   Increases absorption of fluid and electrolytes from the GI tract and increases transit time
§   Decreases levels of serotonin metabolites
§   Also suppresses growth hormone, insulin, and glucagon.
§   Therapeutic Effects:
o    Control of severe flushing and diarrhea associated with GI endocrine tumors.
Uses:
§   Treatment of severe diarrhea and flushing episodes in patients with GI endocrine tumors, including metastatic carcinoid tumors and vasoactive intestinal peptide tumors (VIPomas).
§   Unlabelled Uses:
o    Relief of symptoms and suppressed tumor growth in patients with pituitary tumors associated with acromegaly
o    Management of diarrhea in AIDS patients or patients with fistulas.
Dose:
 prophylaxis following pancreatic trauma or surgery  subcutaneous every 8 hours, 100 mic/kg
 In esophageal varices 50-100 mic IV injection then infusion of 25 – 50 mic/hour for 2-3 days
Contraindications:
§   Hypersensitivity.
Use Cautiously in:
§   Gallbladder disease (increased risk of stone formation)
§   Renal impairment (dosage reduction may be necessary)
§   Hyperglycemia or hypoglycemia (changes in blood sugar may occur) § Fat malabsorption (may be aggravated)
§   Pregnancy or lactation (safety not established).
Side effects:
§   CNS: dizziness, drowsiness, fatigue, headache, weakness.
§   EENT: visual disturbances.
§   CV: edema, orthostatic hypotension, palpitations.
§   GI: abdominal pain, cholelithiasis, diarrhea, fat malabsorption, nausea, vomiting.
§   Derm: flushing.
§   Endo: hyperglycemia, hypoglycemia.
§   Local: injection site pain.
Nursing considerations:
§   Sandostatin ampoules and multi-dose vials should be stored at refrigerated temperatures 2-8°C (36-46°F) and protected from light.
§   Because the drug may result in hypoglycemia or hyperglycemia monitor blood glucose level for the pt.

§   Cardiac conduction abnormalities have also occurred during treatment with Sandostatin so the nurse should monitor the pt's vital signs , ECG…etc.
Item Reviewed: Octreotide : Commonly used drugs in Emergency & ICU Rating: 5 Reviewed By: Unknown