OCTREOTIDE
SOMATOSTATIN ANALOGUE
-is a LONG ACTING somatostatin analogue
USE:
1) CARCINOID TUMORS: note if tumor is in GIT there are no symptoms noticed at 5-HT is metabolized in the liver
2) VIPoma
3) ACUTE VARICEAL BLEEDING
4) ACROMEGALY
AE: abdominal cramps, nausea, steatorrhea, gallstones
TREATMENT OF CARCINOID TUMOR
OCTREOTIDE (somatostatin analogue)
TREATMENT OF VIPoma (Vasoactive Intestinal Polypeptide)
A non α and β islet cell pancreatic tumor that secretes VIP, produce copious diarrhea.
• Source: PANS in sphincters, gall bladder & small intestine
• Increase water and electrolyte secretion, relax intestinal smooth muscle and sphincters
• Treatment with Somatostatin analog: octreotide
TX OF VARICEAL HEMORRHAGE
1) Octreotide: I.V.
A somatostatin derivative with uncertain MOA
Alter portal blood flow and variceal pressure.
Uses: bleeding varices or high risk of repeat bleeding.
Adverse effect: reduce endocrine and exocrine pancreatic activity.
2) NON-SELECTIVE B-BLOCKERS --> Propanolol + Nadolol)
--> are effective in reducing portal pressures
--> β1 & β2 blockade result in ↓CO &↑VC Improves GI blood vessel tone↑systemic vasoconstriction & ↓vasodilation
TX OF REYE'S SYNDROME
- Reye’s syndrome is associated with fatty liver, hypoglycemia, and coma – childhood hepatic- encephalopathy.
This is linked to viral infection treated with aspirin.
Therefore, acetaminophen may be advised in place of aspirin.
