Pharmacology of Octreotide

Publication date: June 2017
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Reza M. Borna, Jonathan S. Jahr, Susanna Kmiecik, Ken F. Mancuso, Alan D. Kaye

Teaser

Many patients presenting with a history of foregut, midgut neuroendocrine tumors (NETs) or carcinoid syndrome can experience life-threatening carcinoid crises during anesthesia or surgery. Clinicians should understand the pharmacology of octreotide and appreciate the use of continuous infusions of high-dose octreotide, which can minimize intraoperative carcinoid crises. We administer a prophylactic 500-μg bolus of octreotide intravenously (IV) and begin a continuous infusion of 500 μg/h for all NET patients. Advantages include low cost and excellent safety profile. High-dose octreotide for midgut and foregut NETs requires an appreciation of the pathophysiology involved in the disease, pharmacology, drug–drug interactions, and side effects.


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