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.