Octreotide

When ATH:
H01CB02

Characteristic.

The synthetic somatostatin analogue.

Pharmacological action.
Somatostatinopodobnoe.

Application.

Akromegalija (the ineffectiveness of dopamine agonists or the impossibility of surgical treatment, radiation therapy), endocrine tumors gastroenteropankreaticheskoy system (relief of symptoms of carcinoid tumors with features of carcinoid syndrome, tumors, characterized by overproduction of vasoactive intestinal peptide), glucagonomas, gastrinoma (Zollinger - Ellison), insuloma, somatoliberinomy, persistent diarrhea in AIDS patients, operations on pancreas (prevention of complications), bleeding (incl. relapse prevention) varicose veins of the esophagus in patients with liver cirrhosis.

Contraindications.

Hypersensitivity, pregnancy, lactation.

Pregnancy and breast-feeding.

Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

Side effects.

Nausea, vomiting, anorexia, abdominal cramping, flatulence, diarrhea and steatorrhea, symptoms of acute intestinal obstruction, abnormal liver function, gallstones (prolonged use), acute pancreatitis, Hyper- or hypoglycemia, hair loss; locally - pain, itching or burning, Krasnoja, swelling.

Cooperation.

Decreases in serum levels of cyclosporine and slows absorption from the gastrointestinal tract of cimetidine and nutrients. It requires a dose adjustment of insulin used simultaneously, oral hypoglycemic drugs, beta-blockers, CCB and diuretics.

Dosing and Administration.

P /, I / (infusion). For acromegaly and tumors of the gastroenteropancreatic system sc - 50-100 mcg 1-2 times a day (up to 100–200 mcg 3 once a day); refractory diarrhea in AIDS n / a - by 100 g 3 once a day (to 250 g 3 once a day). In order to prevent complications after pancreatic surgery, the first dose 100 mcg is injected s / c for 1 h to laparotomy, then after the operation n / c - by 100 g 3 twice a day for seven consecutive days. To stop bleeding from varicose veins of the esophagus or stomach - by 25 mcg / h by continuous intravenous infusion for 5 days.

Precautions.

Substantial fluctuations in blood glucose concentration can be reduced by introducing more frequent smaller doses; it should be understood, gastroenteropankreaticheskih that the treatment of endocrine tumors can not be excluded a sudden recurrence of symptoms, and in patients with insulomas - an increase in the severity and duration of hypoglycemia. A systematic control of blood glucose, especially in patients with bleeding from esophageal varices in cirrhosis, tk. It increases the risk of developing diabetes type 1; changing insulin requirements at already existing diabetes.

Cooperation