Hypoglycemia
Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu in Medical Management of Diabetes Mellitus, 2000
The preceding two methods for dealing with what can be a protracted event are not optimal, especially if the overdose is from long-acting agents, in particular chlorpropamide. Our best treatment success is seen with octreotide administration. Octreotide is a somatostatin derivative that inhibits the secretion of many hormones and is usually used to reduce tumor-induced hypersecretion syndromes, such as growth hormone, in patients with acromegaly. It also inhibits insulin and glucagon release. We have observed in normal subjects taking upward of 100 mg of glipizide that octreotide caused the dextrose infusion requirements to regularly fall to zero. Octreotide can be given subcutaneously and we have anecdotally found that 50 fig every 6-8 h provides much the same result as a continuous infusion of the drug. The major side effect of octreotide therapy is fat malabsorption, thus we generally recommend low-fat meals while this medication is being administered.
Drug therapy for portal hypertension
Michael JG Farthing, Anne B Ballinger in Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Octreotide is a synthetic long-acting somatostatin analogue that has been shown to be significantly more efficient than the native hormone in treating acromegaly and endocrine tumours.62 This greater efficacy arises from the fact that octreotide is significantly more potent than natural somatostatin in inhibiting growth hormone and glucagon release.62 This advantage, in addition to its long half-life and easy administration (octreotide can be administered subcutaneously), have led to the clinical use of octreotide in conditions other than those previously mentioned and in which somatostatin has clearly shown to be highly efficient, such as portal hypertension and its related complications. Although octreotide has been shown to reduce portal pressure in animals,63 however, this effect is uncertain in cirrhotic patients.63, 64
Management of Acute Intestinal Ischaemia
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Drugs that reduce gastrointestinal secretions include gastric-acid–reducing medications, octreotide and clonidine. Acid-reducing medications, such a H2 receptor antagonists and proton pump inhibitors decrease fluid secretions produced by the stomach, approximately 2 L daily. Treatment doses are typically higher than those for treating acid reflux, and proton pump inhibitors appear more effective than H2 antagonists. Octreotide is a synthetic somatostatin analogue that reduces secretions by inhibiting other pro-secretory substances such as gastrin and secretin, amongst others. It can be given intravenously, subcutaneously and as a depot injection. However, octreotide is costly and can cause cholelithiasis and fluctuations in serum glucose levels and is associated with tachyphylaxis. Clonidine is used as an anti-hypertensive because of its α-adrenergic agonist properties, but it also stimulates intestinal fluid absorption and improves diarrhoea. It can be used in both oral and transdermal preparations. Because of its antihypertensive properties, it can exacerbate symptoms of dehydration and orthostatic hypotension; therefore, it must be used with caution.
Octreotide and Octreotide-derived delivery systems
Published in Journal of Drug Targeting, 2023
Mingliang Fan, Yue Huang, Xinlin Zhu, Jiayu Zheng, Mingwei Du
The tetradecapeptide somatostatin is secreted by hypothalamus or delta cells in gastrointestinal tract and interacts with somatostatin receptors (SSTRs), which is a group of GPCRs (G-protein-coupled receptors) with five human receptor subtypes (SSTR 1-5). Somatostatin can inhibit the release of a series of hormones or neuropeptides in many organs, including growth hormone, insulin, glucagon, among others, thus taking important roles in many physiological functions. However, its clinical applications are remarkably restricted by poor circulation time (about 3 min) in the blood. Hence a variety of somatostatin analogs with longer circulation time have been developed for clinical use since 1970s [1]. Among them, Octreotide (SMS 201-995) is the most widely developed representative of somatostatin analog and stands the test of clinical application [2]. As a therapeutic agent and targeting ligand, Octreotide (OCT) has also been involved in the construction of many novel pharmaceutical systems for tumour targeted treatment. Given OCT-derived radionuclide therapy and radionuclide imaging were well reviewed by previous publication [3], we herein focus on the preclinical studies of some novel pharmaceutical delivery systems related to OCT, including microsphere, conjugate, liposome, polymeric nanoparticle, hydrogel and inorganic nanoparticle.
Diagnosis and treatment of malignant-appearing arteriovenous malformation
Published in Baylor University Medical Center Proceedings, 2021
Rebekah John, Gurkarminder Sandhu, Christopher Naumann
The intermittent ischemia caused by contraction of the muscularis propria causes hypoxia, which is known to increase expression of proangiogenic factors. Vascular endothelial growth factor (VEGF) is one such growth factor that has been found in higher quantities in hypoxic environments.5 VEGF inhibitors have been studied in the treatment of AVMs; however, due to their extensive side effect profile, they are not commonly used for long-term treatment.6 Other therapies commonly employed in treatment of AVMs include endoscopic ligation and surgical intervention, as well as argon plasma coagulation. In argon plasma coagulation, an electrical current is combined with argon gas. The gas is ionized and allows a high-frequency electric current to be conducted to the tissue without direct contact. This method decreases tissue depth injury, especially when used in conjunction with a prior submucosal saline injection to the target area to form a cushion.7,8 Pharmacological therapy with octreotide is also commonly used. One study showed that administration of octreotide long-acting release for 6 months resulted in a significant reduction in bleeding episodes and transfusion requirements in patients who had mostly failed argon plasma coagulation therapy.9
Current advances in the management of cluster headaches
Published in Expert Opinion on Pharmacotherapy, 2021
Theodoros Mavridis, Marianthi Breza, Christina Deligianni, Dimos D. Mitsikostas
Octreotide is a somatostatin analog that mimics natural somatostatin by inhibiting serotonin release, and the secretion of gastrin, VIP, insulin, glucagon, secretin, motilin, and pancreatic polypeptide. It provides more potent inhibition of growth hormone, glucagon, and insulin as compared to endogenous somatostatin. Octreotide has a level C recommendation for the acute treatment of CH [29]. Octreotide 100 mg given subcutaneously has shown effectiveness in improving headache response compared to placebo. In terms of response rate and time to initial relief, it is believed to be inferior to both subcutaneous and intranasal sumatriptan [42,43]. The adverse effects (AE) are nonserious and include injection site reactions, diarrhea, abdominal bloating, nausea, dull background headache and dizziness/somnolence [27,29].
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