Octerotid

Clinical Effects:

OCTREOTIDE AND RELATED AGENTS
  • OVERDOSE: Overdose data are limited with these agents; hypoglycemia, flushing, dizziness and nausea have been reported. ADVERSE EFFECTS: Gastrointestinal adverse effects (eg; anorexia, nausea, vomiting, diarrhea and steatorrhea, constipation, abdominal discomfort, and flatulence) are the most common effects. Gallstones, hypoglycemia and hyperglycemia, dizziness, pancreatitis, hypothyroidism, sinus bradycardia, conduction abnormalities, dysrhythmias, thrombocytopenia, and hepatitis have also been reported.

Range of Toxicity:

OCTREOTIDE AND RELATED AGENTS
  • A minimum toxic dose has not been established has not been established for these agents. Overdoses of octreotide up to 120,000 mcg infused over 8 hours have been well tolerated. Octreotide doses of 2.5 mg (2500 mcg) subcutaneously have caused hypoglycemia, flushing, dizziness, and nausea.

Treatment:

OCTREOTIDE AND RELATED AGENTS
  • Decontamination: Significant toxicity is not anticipated after ingestion because of limited bioavailability. Treatment is symptomatic and supportive. Consider activated charcoal only after very large ingestions.
  • Hyperglycemia: If significant hyperglycemia occurs, careful blood glucose monitoring and insulin therapy might be required.
  • Hypoglycemia: Give dextrose if symptomatic or BS <60 mg/dL. Dose – Adult 50 mL of 50% dextrose IV push; Child 0.5 to 1 g/kg (2-4 mL/kg) of 25% dextrose IV push. Feed oral carbohydrates. If recurrent hypoglycemia develops, repeat dextrose bolus and follow with an infusion of 10% dextrose; titrate to a BS of 100 mg/dL.
  • Bradycardia: ATROPINE: ADULT DOSE: BRADYCARDIA: 0.5 to 1 mg IV every 5 min. ASYSTOLE: 1 mg IV every 5 min. Maximum total dose 3 mg or 0.04 mg/kg. Minimum single dose 0.5 mg. PEDIATRIC DOSE: 0.02 mg/kg IV repeat every 5 min, minimum single dose 0.1 mg; maximum single dose child 0.5 mg, adolescent 1 mg; maximum total dose 1 mg child, 2 mg adolescent.
  • Monitoring of patient: Vital signs, liver enzyme levels, blood glucose level, electrolytes and fluid status, ECG, and continuous cardiac monitoring in symptomatic patients.
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