Ver el código de «Octreotide»

==Administration==
*Type: Octapeptide 
*Dosage Forms:
*Routes of Administration: IV, IM, or SQ
*Common Trade Names: Sandostatin, Sandostatin LAR

==Adult Dosing==
===[[Variceal bleeding]]===
*Initial Bolus: 50mcg IV (range 25-100mcg)<ref>Garbuzenko DV. Current approaches to the management of patients with liver cirrhosis who have acute esophageal variceal bleeding. Curr Med Res Opin. 2016:1-9.</ref>
*Drip rate: 25-50 mcg/hr IV

===[[Sulfonylurea toxicity]]===
*50-75 mpg SQ or IM every 6 hrs as needed

==Pediatric Dosing==
===Sulfonylurea Overdose===
*1-2 mpg/kg SQ or IM

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Octreotide crosses the placenta and can be detected in newborn at birth. Limited data on risk, case studies have not demonstrated any congenital malformations in fetuses. 
*[[Lactation risk categories|Lactation risk]]:
===Renal Dosing===
*Dialysis patients: dosage adjustment may be required as clearance is reduced by ~50%.

===Hepatic Dosing===
No adjustments needed but clearance is reduced in patients with cirrhosis.

==Contraindications==
*Allergy to class/drug

==Adverse Reactions==
*[[Hypoglycemia]] is rare but more common in older adults and type I diabetics<ref>Howland MA, Smith SW. Antidotes in depth. In: Robert S. Hoffman, et al., ed. Goldfrank’s toxicologic emergencies. 10e ed. ; 2015.</ref>

====Serious====
* pancreatitis
* bradycardia 
* arrhythmias
* anaphylaxis
* thrombocytopenia 

====Common====
* nausea/vomiting/diarrhea
* dizziness
* fatigue
* edema
* pruritus

==Pharmacology==
*Half-life: 1.5-2 hrs<ref name="metabolism">Chanson P et al. Clinical pharmacokinetics of octreotide. Therapeutic applications in patients with pituitary tumours. Clin Pharmacokinet. 1993 Nov;25(5):375-91.</ref>
*Metabolism: Hepatic<ref name="metabolism"></ref>
*Excretion: Renal

==Mechanism of Action==
A peptide that mimics endogenous somatostatin. Somatostatin is released by the pancreas, pyloric antrum, and duodenum and inhibits Growth Gormone, Gastrin, Vasoactive intestinal peptide (VIP), Gastrin, Serotonin, and decreases Insulin like growth factor-1 (IGF-1), serotonin and it decreases splanchnic blood flow.

==Comments==
*Although used in the ED mainly for sulfonylurea overdose and variceal bleeding, it is used in outpatient and inpatient medicine for the treatment of acromegaly, carcinoid tumors, and VIPomas
*Octreotide was originally used as a opioid antagonist and is still used off label as a second/third line therapy for diarrhea from opioid withdrawal because of antidiarrheal properties.<ref>Carreno JE et al. 24-hour opiate detoxification and antagonist induction at home– the ‘asturian method’: A report on 1368 procedures. Addict Biol. 2002;7(2):243-250.</ref>

==See Also==
*[[Upper GI Bleed Guidelines]]
*[[Upper gastrointestinal bleeding]]

==References==
<references/>
[[Category:Pharmacology]][[Category:GI]]