Octreotide
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2008-06-22T18:53:13Z
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{{drugbox
| IUPAC_name = (4''R'',7''S'',10''S'',13''R'',16''S'',19''R'')-10-(4-aminobutyl)-19-<br><nowiki>[[</nowiki>(2''R'')-2-amino-3-phenyl-propanoyl]amino]-16-<br>benzyl-''N''-[(2''R'',3''R'')-1,3-dihydroxybutan-2-yl]-7-<br>(1-hydroxyethyl)-13-(1''H''-indol-3-ylmethyl)-6,9,12,<br>15,18-pentaoxo-1,2-dithia-5,8,11,14,17-<br>pentazacycloicosane-4-carboxamide
| image = Octreotide.svg
| image2 = Octreotide3d.png
| CAS_number = 83150-76-9
| ATC_prefix = H01
| ATC_suffix = CB02
| ATC_supplemental =
| PubChem = 54373
| DrugBank = BTD00088
| C = 49 | H = 66 | N = 10 | O = 10 | S = 2
| molecular_weight = 1019.24 g/mol
| bioavailability = 100%; [[Intramuscular Injection|I.M]]: 60% to 63% of subcutaneous dose
| protein_bound = 65%
| metabolism = [[Hepatic]]
| elimination_half-life = 1.7-1.9 hours
| pregnancy_US = B
| legal_status =
| routes_of_administration = [[Intramuscular injection|Intramuscular]], [[Intravenous therapy|intravenous]]
}}
'''Octreotide''' (brand name '''Sandostatin''', [[Novartis|Novartis Pharmaceuticals]]) is an [[peptide|octapeptide]] that mimics natural [[somatostatin]] pharmacologically, though it is a more potent inhibitor of [[growth hormone]], [[glucagon]], and [[insulin]] than the natural hormone. It was first synthesized in 1979 by the chemist Wilfried Bauer.
==Pharmaceutical Effects==
Since '''octreotide''' resembles somatostatin in physiological activities, it can:
* Inhibit secretion of many hormones, such as [[gastrin]], [[cholecystokinin]], [[glucagon]], [[growth hormone]], [[insulin]], [[secretin]], [[pancreatic polypeptide]], [[TSH]], and [[vasoactive intestinal peptide]].
* Reduce secretion of fluids by the intestine and [[pancreas]].
* Reduce gastrointestinal motility and inhibits contraction of the [[gallbladder]].
* Inhibit the action of certain hormones from the [[anterior pituitary]].
* Cause [[vasoconstriction]] in the blood vessels.
==Adverse Effects==
Some of the formulations of this drug show some adverse effects, most important of which is the QT-Interval prolonging. As a rule, a drug that causes prolonged QT-Interval shall have Drug-Drug Interaction possibilities. This indicates that giving such drug shall be of care so that no severe interactions can occur.
'''Octreotide''' usually shows certain commonly observed adverse effects that differ in the frequency from patient to another:
'''''Most Frequent Adverse Effects:'''''
Abdominal Pain with Cramps, Bradycardia, Conduction Disorder of the Heart, Constipation, Diarrhea, Disorder of the Digestive System, Injection Site Sequelae, Nausea, Vomiting
'''''Less Frequent Adverse Effects:'''''
Discolored Feces, Dyspepsia, Flatulence, Hypothyroidism, Steatorrhea, Tenesmus
'''''Rare Adverse Effects:'''''
Acute Pancreatitis, Alopecia, Biliary Calculus, Disease of Liver, Dizziness, Edema, Fatigue, Fever, Flushing, General Weakness, Headache Disorder, Hepatitis, Hyperbilirubinemia, Hyperglycemia, Hypoglycemic Disorder, Prolonged QT Interval
Keep in mind that this drug can cause diarrhea despite the fact of being used in the treatment of diarrhea!
==Uses==
The [[Food and Drug Administration]] (FDA) has approved the usage of a salt form of this peptide, ''octreotide [[acetate]]'', as an <!-- should work on marking up "depot" or "injectable depot" and "formulation" either to wikipedia or wiktionary --> injectable depot formulation for the treatment of [[acromegaly]], the treatment of [[diarrhea]] and [[Flushing (physiology)|flushing]] episodes associated with [[carcinoid syndrome]], and treatment of diarrhea in patients with [[vasoactive intestinal peptide]]-secreting tumors ([[VIPoma]]s).
Octreotide has also been used [[off-label use|off-label]] for the treatment of severe, refractory diarrhea from other causes. It is used in toxicology for the treatment of prolonged recurrent hypoglycemia after [[sulfonylurea]] overdose.
Octreotide has also been used with varying degrees of success in infants with nesidioblastosis to help decrease insulin hypersecretion.
In patients with suspected [[esophageal varices]], octreotide can be given to help decrease bleeding.
Octreotide has been investigated for patients with pain from [[chronic pancreatitis]].<ref name="pmid10207228">{{cite journal |author=Uhl W, Anghelacopoulos SE, Friess H, Büchler MW |title=The role of octreotide and somatostatin in acute and chronic pancreatitis |journal=Digestion |volume=60 Suppl 2 |issue= |pages=23–31 |year=1999 |pmid=10207228 |doi=10.1159/000051477}}</ref>
Octreotide may be useful in the treatment of thymic neoplasms.
Octreotide has been used as an unlicensed drug, injected sub-cutaneously in the management of hypertrophic pulmonary osteoarthropathy (HPOA), secondary to non-small cell lung carcinoma. Although its mechanism is not known it appears to reduce the pain associated with HPOA
==References==
<references/>
* {{cite book | editor = Katzung, Bertram G. (ed.) | title = Basic and Clinical Pharmacology | publisher = Lange Medical Books/McGraw Hill | location = Stamford, Conn | year = 2004 | id = ISBN 0-07-141092-9}}
==External links==
*[http://www.caringforcarcinoid.org Caring for Carcinoid Foundation]
*[http://www.sandostatin.com Sandostatin (Octreotide) brand homepage]
* [http://www.indevus.com/site/index.php?Itemid=63&id=64&option=com_content&task=view] Indevus Pharma and Octreotide
[[Category:Hormonal agents]]
{{Pituitary and hypothalamic hormones and analogues}}
[[de:Octreotid]]
[[pl:Oktreotyd]]
[[pt:Octreotida]]