Octreotide and it's use for Esophageal Varices
Varices are commonly seen in patients with cirrhosis of the liver. Normal blood flow to the liver is obstructed so blood tends to seek a way around the scarring/obstruction and flows into smaller vessels that aren't meant to carry as much blood.
The result are these bulging varices that can leak blood or even rupture, which is considered a medical emergency.
Octreotide, a somastatin analog, is one of the main drugs of choice for bleeding varices.
Octreotide helps to reduce portal venous flow and pressure, resulting in reduced bleeding.
Its site of action is relatively specific, unlike the formally used vasopressin, therefore a lot less systemic side effects occur.
Typically given as 50-100mcgs in an IV bolus dose, followed by a 25-50mcg/hour IV infusion. It can be used for up to five days.
The patient should be monitored for diarrhea with an eye kept on their glucose levels (as somatostatin can influence insulin levels), heart rate, and blood pressure.
Generally used as prophylaxis for patients who may also have ascites and be at risk for spontaneous bacterial peritonitis.
