Pharmacology

1. 
   

   Octreotide is a synthetic polypeptide and a long-acting analog of somatostatin. It significantly antagonizes pancreatic insulin release and is useful for the management of hypoglycemia resulting from drug-induced endogenous secretion of insulin.

   
   
2. 
   

   Octreotide also suppresses pancreatic function, gastric acid secretion, and biliary and GI tract motility.

   
   
3. 
   

   As a polypeptide, it is bioavailable only by parenteral administration (intravenously or subcutaneously). Approximately 30% of octreotide is excreted unchanged in the urine, and it has an elimination half-life of 1.7 hours. Its half-life may be increased in patients with renal dysfunction and in the elderly.

Indications. Oral sulfonylurea hypoglycemic overdose (See Antidiabetic Agents) or quinine-induced hypoglycemia (See Quinine) when serum glucose concentrations cannot be maintained with an intravenous 5% dextrose infusion. It may also be considered a first-line agent along with dextrose because it can reduce glucose requirements and prevent rebound hypoglycemia in patients with sulfonylurea poisoning. This agent is preferred over diazoxide (See Diazoxide). It is not used in the management of exogenous insulin poisoning, where it has a theoretic disadvantage of blocking beneficial counterregulatory reactions (prevents glucagon and growth hormone secretion) to hypoglycemia.

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