Octreotide

Chemical name

Synthetic oktapeptid, derivative somatostatin

Gross

C49-H66-N10-O10-S2

Of drugs

The drugs - соматостатиноподобно е. It stops production of growth hormone, reduces glukagona secretion, insulin, serotonin, gastrina, vazoaguogo intestinalnogo peptide, secretin, and motilina pankreaticski polypeptid. Decreases in the bloodstream viszeralnah bodies. Alleviate symptoms associated with metastasis carcinoid tumors (tides and diarrhoea), increased allocation (adenoma) vazoaguogo intestinalnogo peptide (diarrhoea), glukagona (diarrhoea, lower body mass index, nekrotizirutaya NIMBY rash), insulin (hypoglycaemia). Significantly reduces the concentration of growth hormone and / or somatomedin C in patients akromegaliei, products tireotropina, driven tireoliberinom. Oppressing airway gall bladder, suppresses the flow of bile in dwenadzatiperstnuu rectum. After p / to the injections (derived effects directly proportional to the concentration in the plasma and does not differ from any of the / in the introduction) rapidly and completely absorbed. C_max (up to 5.2 mg / ml dose of 100 µ g) is achieved within 25 to 30 minutes. Most (65%) associated with plasma with lipoproteinami, to a lesser extent with albuminami. T_1/2 after injection of 100 min. Length of variabelna, on average, about 12 hours, depending on the type of tumor. About 32% imposed dose excreted unchanged to the urine. Older patients Cl oktreotida slows and T_1/2 increasing. In severe kidney failure that requires dialysis, Cl reduced by half.

Indications

Akromegalia (with the poor showing agonists or inability to surgical treatment, radiation therapy), endocrine tumours гастроэнтеропанкреат ической system (mild symptomatic carcinoid tumors with signs kartsinoidnyi syndrome tumors characterized giperprodukciei vazoaguogo intestinalnogo peptide), glukagonoma, gastrinoma (syndrome Zollinger-Ellison), insuloma, somatoliberinoma, refrakternaya diarrhoea in AIDS patients, operations on the pancreas (prevention of complications), bleeding (including relapse prevention) to treat varicose veins esophagus in patients with cirrhosis of the liver.

Contraindications

Hypersensitivity, pregnancy and breast-feeding (at the end of treatment).

Side-Effects

Nausea, vomiting, anorexia, spasticskie pains in the abdomen, bloating, diarrhoea and steatorea, the symptoms of acute intestinal obstruction, violation of the liver, education biliary stones (with the long-term use), acute pancreatitis, or hypermarkets hypoglycaemia, hair loss; Local-pain, a sense of itching or stinging, erythema, swelling.

Patient interaction

Impact of cyclosporine in the cell and slows down the absorption of blood zimetidina and nutrients. A dose adjustment at the same time of insulin, oral gipoglikemicakih preparations beta-adrenoblokatorov, blocking calcium channels and mochegonnah funds.

Precautions

Substantial variation of glucose in the blood can be reduced more frequent introduction of smaller doses; It should be borne in mind that in the treatment of гастроэнтеропанкреат ических endocrine tumors not excluded sudden relapse symptoms, in patients with insoulomami-increasing extent and duration gipoglikemii. A systematic monitoring concentrations of glucose, especially in patients with bleeding from varikozno expanded veins in the digestive cirrhosis of the liver, because increased risk of insulinzawisimogo diabetes; change the need for insulin in the existing diabetes.

Dosing and Administration

P / to, in / in (infuzionno). In akromegalia and tumours гастроэнтеропанкреат ической the p / c on 50-100 µ g 1-2 times per day (up to 200 µ g three times a day); refractor diarrhea in AIDS s / by-100 µ g three times a day (up to 250 µ g three times a day). In order to prevent complications after operations on the pancreas first dose of 100 µ g impose s / to 1 hour before Chapter, and then after the operation p / to-100 micrograms three times a day for seven consecutive days. To stop bleeding from the varikozno expanded veins oesophagus and stomach, and 25 µ g / h by continuing to / in infusions for five days.

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