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OCTREOTIDE [USES/SIDE EFFECTS/WARNING]
Could be:
SandoSTATIN
SandoSTATIN LAR Depot
Octreotide Acetate Omega
Class
Antidiarrheal
Antidote
Somatostatin analog
Forms
Intramuscular kit:
SandoSTATIN LAR Depot== 10mg, 20mg, 30mg
Injection:
SandoSTATIN 50ug/ml, 100ug/ml, 200ug/ml, 500ug/ml, 1000ug/ml
Through I.V/SubQ/ I.M/ Depot
Uses
1. DM
2. Chemotherapy
3. HIV
4. Graft vs Host
5. Carcinoid
6. Medullary Thyroid CA
7. VIPoma's
8. Short Bowel Syndrome
9. Bone Marrow Transplant
10. All Chronic Diarrhea
11. Zollinger – Ellison Syndrome
12. Thymoma/ Advanced Thymic Malignancy
13. Sulfonylurea – induced hypoglycemia
14. Malignant Bowel Obstruction
15. Hepatorenal Syndrome
16. Gastroesophageal variceal hemorrhage
17. Gastro –Entero- Pancreatic neuroendocrine tumors[metastic]
18. Acromegaly
19. Hypothalamic Obesity
Acromegaly
Sub or I.V
50ug TID
Up to 100ug TID
Maximum range is 300ug to 1500ug/day
Have med stopped for 4/52 every one year
Check GH, IGF[Insulin-like Growth factor 1]
Switching to Depot from SubQ:
Stability on SubQ x 2/52, then
Switch to the Depot
Give 20mg l.M. q 4/52 x 3/12
Review your parameters if the GH is less than or equal to 1ng/ml
IGF – 1 i.e. insulin, like growth factor-1 is normal,
then reduce Octreotide to 10mg I.M q 4/52
Titrate the dose based on GH and IGF – 1 levels
e.g. if GH is greater than 2.5ng/ml and IGF – 1 is elevated, then increase octreotide to 30mg I.M q4/52
If you have used maximum octreotide and not winning, add Pegvisomant [growth hormone receptor antagonist] or a Dopamine agonist
Carcinoid Crisis (Intra-operatively)
With hypotension
I.V. 500 to 1000ug bolus
Repeat at 5 minute intervals
Until symptoms are controlled
OR the bolus to be followed by 50-200ug per hour continuous infusion during the procedure
AND MANY MORE FACTS,ENJOY LISTENING!
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