In this episode, I’ll discuss octreotide’s role in treating variceal bleeding.
Octreotide is a long-acting analog of somatostatin. It inhibits the release of many endocrine peptides including insulin and glucagon. In addition, it inhibits the release of gastric acid. Because glucagon is a vasodilator, octreotide indirectly decreases splanchic blood flow by its action inhibiting the release of glucagon. This decrease in blood flow to the site of bleeding is believed to be the main way octreotide helps in variceal bleeding.
Using octreotide does not provide a benefit in terms of decreased mortality, but it does affect other meaningful outcomes. A meta-analysis of over 800 patients found that a little over 1 unit of blood products was saved per each patient treated. A small prospective randomized trial comparing octreotide with vasopressin found that octreotide resulted in more initial hemostasis, less re-bleeding, and nearly twice the rate of complete control of bleeding within 24 hours.
Members of my Hospital Pharmacy Academy have access to my in-depth training on the pharmacist’s role in treating acute upper GI bleeding. This is in addition to over 75 other in-depth training videos, weekly literature digests to help you stay up to date, full-text journal access and forums to interact with me and the other members. The purpose of the Academy is to increase the confidence and clinical skills of hospital-based pharmacists in the areas of critical care, emergency medicine, infectious disease, and general hospital pharmacy. To learn more or join go to pharmacyjoe.com/academy.
If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.