OCTREOTIDE (Sandostatin)

• inhibits pathologically increased secretion of peptides and serotonin produced within the gastroentero-pancreatic (GEP) endocrine system and growth hormone, thus used in pancreatitis or post pancreatic surgery to prevent complications such as pancreatic fistula or abscess
• thought to reduce splanchnic blood flow primarily by inhibiting vasoactive gastrointestinal hormone secretion and exerting a direct vasomotor effect on splanchnic vessels, thus reducing portal blood flow;  used in the emergency management of bleeding gastroesophageal varices in patients with cirrhosis

• 50 - 100 ug IV bolus
• 25 - 50 ug/hour IV infusion for 1 to 5 days
   

To reduce gastrointestinal output or pancreatic fistula secretions:

• 50 - 200 ug every 8 hours or 250 ug/hour by continuous infusion for 48 hours (followed by subcuntaneous dosing)

SC dose:  ensure site rotated with each dose

IV Bolus dose:

• 50 ug in 50 mL sodium chloride 0.9% or dextrose 5% over 10 minute

IV Infusion:

• 500 ug in 250 mL sodium chloride 0.9% or dextrose 5%

Cardiovascular:

• flushing, edema, chest pain, congestive heart failure

• palipitations
• hypertension, orthostatic hypotension
• sinus bradycardia or conduction abnormalities

Neurological:

• Bell's Palsy
• fatigue
• vertigo, dizziness
• anxiety, depression, insomnia
• seizures, hyperesthesia, chills

Respiratory:

• shortness of breath
• rhinorrhea
   

Endocrine:

• hyper- or hypo-glycemia
• galactorrhea, hypothyroidism

Dermatologic:

• erythema, puritis
• alopecia
• bruising
• injection site pain (SC)

Gastrointestinal:

• altered absoprtion of dietary fats, steatorrhea
• gallstones formation, biliary sludge, pancreatitis
• dyspepsia, nausea, vomiting, diarrhea, flatulence
• xerostomia
• elevated liver enzymes, hepatitis, jaundice

Musculoskeletal:

• weakness, muscle spasms
• arthralgia, tremors, numbness
• elevated creatinine kinase 

Ocular:

• visual disturbances, ocular burning

Renal:

• oliguria, increased urine osmolarity
• prostatitis

• oral cyclosporin + octreotide  = delayed and reduced absorption of cyclosporin

• heart rate
• blood pressure
• blood glucose
• amylase, lipase, bilirubin, liver function tests
• bowel function
• skin
• presence of hematemesis or melena
• Hemoglobin

• May be administered IV direct by a nurse in Adult Critical Care
• IV direct by physician only
• Continuous infusions must be administered by infusion device and the pump library must be enabled