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Journal of Pain and Symptom Management Aug 1994Octreotide, an analogue of somatostatin with a more favorable pharmacokinetic profile, is a new drug that may offer some advantages in the palliative care setting. It... (Review)
Review
Octreotide, an analogue of somatostatin with a more favorable pharmacokinetic profile, is a new drug that may offer some advantages in the palliative care setting. It has been used with favorable results in the management of some gastrointestinal disorders, such as gastrointestinal hemorrhage, diarrhea, short-bowel syndrome, fistula, and intestinal occlusion in the palliative care setting. These favorable results occurred without important side effects, underlining the potential role of this drug. The cost-benefit ratio of this expensive drug must be considered, however.
Topics: Gastrointestinal Diseases; Humans; Octreotide; Palliative Care
PubMed: 7525789
DOI: 10.1016/0885-3924(94)90178-3 -
American Journal of Surgery Oct 1996Octreotide is a long-acting analogue of somatostatin that exhibits good subcutaneous absorption. It reduces gastrointestinal and pancreatic secretions as well as relaxes... (Review)
Review
BACKGROUND
Octreotide is a long-acting analogue of somatostatin that exhibits good subcutaneous absorption. It reduces gastrointestinal and pancreatic secretions as well as relaxes the intestinal musculature. It has been hypothesized that octreotide could decrease fistula output, thus facilitating fluid and electrolytes management and possibly hasten fistula closure.
DATA SOURCES
Relevant articles were identified from a MEDLINE search of the literature. Because of the scarcity of well-designed studies on the use of octreotide to promote enterocutaneous and pancreaticocutaneous fistulas closure, all case series and controlled trials were reviewed.
CONCLUSIONS
Octreotide as an adjuvant to standard fistula management diminishes fistula output, but its shortening of the time to fistula closure remains to be proven by well-designed comparative trials. For recent onset fistulas (less than 8 days old), octreotide does not seem better than the recommended management, including parenteral nutrition. Octreotide can effectively prevent postoperative complications and fistula formation in patients undergoing elective pancreatic resection.
Topics: Adolescent; Adult; Aged; Cutaneous Fistula; Cyclosporine; Drug Interactions; Hormones; Humans; Middle Aged; Octreotide; Pancreatic Fistula
PubMed: 8873537
DOI: 10.1016/S0002-9610(96)00193-6 -
Gastroenterology Nursing : the Official... Dec 1992Sandostatin is an antineoplastic drug used to control diarrhea and improve hypokalema in patients with metastatic carcinoid tumors and vasoactive intestinal...
Sandostatin is an antineoplastic drug used to control diarrhea and improve hypokalema in patients with metastatic carcinoid tumors and vasoactive intestinal peptide-secreting tumors. Sandostatin has been used to treat life-threatening hypotension and acromegaly. Sandostatin has also been used after endoscopic retrograde cholangiopancreatography to reduce the motility of the pancreas. Generally side effects of Sandostatin are rare and medically manageable when recognized. Chronic therapy with Sandostatin warrants monitoring of serum electrolyte and blood glucose levels. Baseline thyroid studies should be investigated prior to therapy and monitored throughout therapy. Sandostatin may alter fat absorption and gallbladder function; therefore, monitoring of appropriate laboratory values and ultrasonography studies may also be indicated.
Topics: Humans; Octreotide; Patient Education as Topic
PubMed: 1472557
DOI: 10.1097/00001610-199212000-00008 -
European Journal of Cardio-thoracic... Jan 2024Chylothorax is a complex condition and many different pharmacological agents have been tried as treatment. Octreotide is used off-label to treat chylothorax, but the... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Chylothorax is a complex condition and many different pharmacological agents have been tried as treatment. Octreotide is used off-label to treat chylothorax, but the efficacy of octreotide remains unclear. A decrease in lymph production is suggested as the mechanism. In this cross-over study, we explore the direct effect of octreotide on human lymphatic drainage.
METHODS
Pre-clinical: the effect of octreotide on force generation was assessed during acute and prolonged drug incubation on human lymphatic vessels mounted in a myograph. Clinical: in a double-blinded, randomized, cross-over trial including 16 healthy adults, we administered either octreotide or saline as an intravenous infusion for 2.5 h. Near-infrared fluorescence imaging was used to examine spontaneous lymphatic contractions and lymph pressure in peripheral lymphatic vessels and plethysmography was performed to assess the capillary filtration rate, capillary filtration coefficient and isovolumetric pressures of the lower leg.
RESULTS
Pre-clinical: human thoracic duct (n = 12) contraction rate was concentration-dependently stimulated by octreotide with a maximum effect at 10 and 100 nmol/l in the myograph chamber. Clinical: spontaneous lymphatic contractions and lymph pressure evaluated by near-infrared fluorescence did not differ between octreotide or placebo (P = 0.36). Plethysmography revealed similar capillary filtration coefficients (P = 0.057), but almost a doubling of the isovolumetric pressures (P = 0.005) during octreotide infusion.
CONCLUSIONS
Octreotide stimulated lymphatic contractility in the pre-clinical setup but did not affect the spontaneous lymphatic contractions or lymph pressure in healthy individuals. Plethysmography revealed a doubling in the isovolumetric pressure. These results suggest that octreotide increases lymphatic drainage capacity in situations with high lymphatic afterload.
Topics: Adult; Humans; Octreotide; Chylothorax; Gastrointestinal Agents; Cross-Over Studies; Lymphatic Vessels
PubMed: 37951584
DOI: 10.1093/ejcts/ezad380 -
Revista Clinica Espanola May 1992
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Journal of Labelled Compounds &... Sep 2019This study aims at analyzing complexation properties of two new short somatostatin analogues, their synthesis, radiolabeling with Sc, Bi, and Eu and stability in...
This study aims at analyzing complexation properties of two new short somatostatin analogues, their synthesis, radiolabeling with Sc, Bi, and Eu and stability in vitro. Short tetrapeptide Phe-d-Trp-Lys-Thr and pentapeptide Thz-Phe-d-Trp-Lys-Thr were first conjugated with the DOTA macrocyclic chelator. These conjugates were radiolabeled with Sc, Bi, and Eu and characterized by thin-layer chromatography (TLC) and HPLC. The radiochemical purity was measured using digital autoradiography and gamma spectrometry. Optimum conditions of DOTA-conjugate labeling were found: 0.1mM, pH 8.0 to 8.4 at 90°C for DOTA-tetrapeptide complexes with Bi and Eu; 0.05mM, pH 4.0 to 5.0 at 90°C for Sc-DOTA-tetrapeptide; 0.2mM, pH 4.0 to 5.0 at 90°C for Sc-DOTA-pentapeptide. Complexes of DOTA-pentapeptide with Bi and Eu of radiochemical purity more than 95% were probably unstable at temperature higher than 37°C and were obtained at 37°C, pH 8.0 to 8.4 within 4 days. Mass spectra of the Eu-DOTA-pentapeptide revealed the presence of small fragments of the pentapeptide conjugate in the complex solution. in vitro stability studies were performed in saline in the presence of serum proteins and biologically relevant metal cations. All complexes demonstrated no cation release in vitro within 1 to 4 hours.
Topics: Amino Acid Sequence; Animals; Drug Stability; Heterocyclic Compounds, 1-Ring; Isotope Labeling; Octreotide; Positron-Emission Tomography; Radiochemistry; Radiopharmaceuticals
PubMed: 31410877
DOI: 10.1002/jlcr.3799 -
Supportive Care in Cancer : Official... Oct 2008Octreotide acetate was developed as a pharmacologically stable, long-acting analogue of the hormone somatostatin. Mimicking the actions of somatostatin, octreotide has... (Review)
Review
Octreotide acetate was developed as a pharmacologically stable, long-acting analogue of the hormone somatostatin. Mimicking the actions of somatostatin, octreotide has been used for its antisecretory effects. Randomized control trials have established the efficacy of octreotide for malignant bowel obstruction and for chemotherapy-induced diarrhea. Octreotide has proven to be an effective agent for symptoms of carcinoid syndrome. Newer uses include for bone marrow transplantation, infectious diarrheal syndromes, and management of hepatic metastases. More evidence is needed for the establishment of its efficacy for hypercalcemia, pain, pleural effusions, diarrhea after celiac plexus block, and malignant ascites.
Topics: Antineoplastic Agents, Hormonal; Drug Interactions; Humans; Neoplasms; Octreotide; Palliative Care
PubMed: 18256859
DOI: 10.1007/s00520-007-0399-4 -
Presse Medicale (Paris, France : 1983) Dec 1993Octreotide, the first somatostatin analogue developed, has pharmacological properties (it inhibits pituitary GH and TSH secretion, pancreatic and digestive tract... (Review)
Review
Octreotide, the first somatostatin analogue developed, has pharmacological properties (it inhibits pituitary GH and TSH secretion, pancreatic and digestive tract endocrine secretion and various gastrointestinal functions) which are qualitatively similar to those of the natural 14 amino acids peptide. Enzymatic structural modification had resulted in a peptide which is very resistant to degradation and has a 90-110 min half-life permitting subcutaneous administration. Following a subcutaneous injection of 50 to 100 micrograms, absorption is rapid and complete. The peak plasma concentration is obtained within 20 to 30 minutes. The drug is degraded mostly in the liver. Among pituitary tumours, GH- and TSH-secreting adenomas constitute the primary indication. Octreotide has been widely tested in the treatment of acromegaly; 50 to 80 percent of patients with that disease respond to a discontinuous administration (usually 3 subcutaneous injections per day), and the IGF1 level is normalized in 50 percent of the cases. No long-term desensitization and no rebound phenomenon after drug withdrawal have been observed. Clinical improvement is obvious, even in cases with partial response to treatment. The dose required to obtain maximum response may vary from one patient to another, and resistance to the peptide has been observed in a few patients. This resistance does not seem to be related solely to the absence of somatostatin receptors on the tumours. The principal side-effect of octreotide treatment is the occurrence of gallstones. In some patients, continuous subcutaneous injection gives a better result with a lower dose. Other ways of administration (nasal or oral) have been tested or are being evaluated.
Topics: Acromegaly; Adenoma; Gastric Mucosa; Gastrointestinal Transit; Humans; Islets of Langerhans; Octreotide; Pituitary Gland, Anterior; Pituitary Neoplasms; Somatostatin
PubMed: 7907419
DOI: No ID Found -
Journal of Paediatrics and Child Health 2006Chylothorax is the most common cause of pleural effusion causing respiratory distress in the neonate. Cases unresponsive to conservative management usually require... (Review)
Review
Chylothorax is the most common cause of pleural effusion causing respiratory distress in the neonate. Cases unresponsive to conservative management usually require surgery. We report a case of spontaneous neonatal chylothorax where surgery was avoided with the compassionate trail of octreotide. The chylothorax resolved promptly with no observed side effects. After reviewing the literature reporting the use of octreotide in the neonatal period, we found that neonates with isolated spontaneous chylothorax might be viewed as a group different from those with major cardiac malformations. They are at a lower risk for adverse effect of octreotide and lower threshold for commencement of octreotide may benefit them most.
Topics: Chylothorax; Gastrointestinal Agents; Hong Kong; Humans; Infant, Newborn; Male; Octreotide; Pleural Effusion; Treatment Outcome
PubMed: 16487393
DOI: 10.1111/j.1440-1754.2006.00788.x -
Drugs in R&D Sep 2018Octreotide is a somatostatin analogue and has been used off-label for a variety of conditions. There are no specific guidelines for the use of octreotide in neonates and...
BACKGROUND AND OBJECTIVE
Octreotide is a somatostatin analogue and has been used off-label for a variety of conditions. There are no specific guidelines for the use of octreotide in neonates and its safety and efficacy have not been systematically evaluated. The objective of this study is to present our experience of using octreotide therapy in neonates.
METHODS
This is a retrospective study of neonates who received octreotide therapy during their hospital stay over a 15 years period (2003-2017) in a tertiary neonatal centre. The demographic details and indications of octreotide therapy including time of initiation, route, dose, duration and adverse effects of therapy were noted. The clinical course following octreotide administration was also analysed.
RESULTS
Eleven neonates received octreotide therapy during the study period, of which nine had chylothorax and two had chylous ascites. Resolution of the chylous effusion with octreotide therapy was achieved in 4 out of 11 (36.3%) of the cases. The median duration of octreotide therapy in cases with successful resolution was 17.5 days. With the exception of minor side effects such as hyperglycaemia, none of the patients had any significant side effects that required discontinuation of therapy.
CONCLUSION
Octreotide was used safely as an adjunctive therapy for the treatment of chylothorax and chylous ascites in neonates. However, larger prospective controlled trials are required to establish the optimal dose, time of initiation, duration and efficacy of octreotide therapy in neonates.
Topics: Chylothorax; Chylous Ascites; Combined Modality Therapy; Female; Humans; Infant, Newborn; Male; Octreotide; Retrospective Studies
PubMed: 29948779
DOI: 10.1007/s40268-018-0237-9