Diminishing Efficacy of Octreotide (SMS 201-995) on Gastric Functions of Healthy Subjects During One-Week Administration

Londong, W.; Angerer, Michael; Kutz, K; Landgraf, R.; Londong, V.

doi:10.1016/s0016-5085(89)80069-1

Cited by 47 publications

(23 citation statements)

References 38 publications

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“…In the antrum, octreotide reduces the frequency of contractions [19]. This supports findings that octreotide delays the gastric emptying of solids [20].…”

Section: Octreotidesupporting

confidence: 83%

Small bowel dysmotility

Soffer

1998

Curr Treat Options Gastro

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The most important initial step in treating patients with intestinal dysmotility is to exclude reversible causes, in particular mechanical obstruction. The presence or absence of bacterial overgrowth should be determined by small bowel aspirate or breath test, although an empiric trial with antibiotics is an appropriate alternative. Physicians should use agents effective against gram-negative organisms, such as broad-spectrum penicillins or tetracycline, particularly those that provide coverage of anaerobes, such as metronidazole. Nutritional support, by enteral or parenteral means, is currently the most important aspect of management of patients with severe intestinal dysmotility. A low-fat diet, supplemented by liquid formulas, can be tried first. The presence of gastroparesis should be determined; if severe, jejunal feeding should be attempted. Because of the costs and risks associated with total parenteral nutrition (TPN), every attempt should be made to use the native intestine for feeding. A trial of several days of naso-jejunal feeding can help select those patients who can obtain sufficient nutrition by enteral routes and is recommended prior to committing a patient to TPN therapy. Even while on TPN, some oral intake should be encouraged. Prokinetic agents currently in use are less effective in the small bowel than they are in the stomach. They should always be tried initially, though, particularly because improvement of concomitant gastric dysmotility can alleviate symptoms. Although certain manometric patterns can select those patients who respond better to therapy, manometry should not be used to direct therapy in individual patients. For the moment, cisapride is the drug of choice. Erythromycin, particularly when given intravenously and in small, sub-antibiotic doses, can also be tried. The role of octreotide is not clear, but when given at small doses, and when combined with erythromycin, it may be useful in selected patients. Ablative surgery may be useful in a few, highly selected patients. One of the most beneficial surgical procedures is a venting jejunostomy. The use of this simple intervention can substantially reduce the number of hospital admissions and emergency room visits in selected patients with intermittent obstructive symptoms.

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“…In the antrum, octreotide reduces the frequency of contractions [19]. This supports findings that octreotide delays the gastric emptying of solids [20].…”

Section: Octreotidesupporting

confidence: 83%

Small bowel dysmotility

Soffer

1998

Curr Treat Options Gastro

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“…This may be a result of reduced transit times from the stomach to cecum with octreotide, given that most people had small bowel involved in their obstruction. 30 Hisanaga et al 31 noted in a prospective study of 46 similar patients that only two symptoms did not improve on octreotide: the number of vomiting episodes and abdominal pain in the first four days of treatment. Mystakidou et al 14 also reported no change in pain at Days 3 and 6.…”

Section: Discussionmentioning

confidence: 97%

Double-Blind, Placebo-Controlled, Randomized Trial of Octreotide in Malignant Bowel Obstruction

Currow

Quinn

Agar³

et al. 2015

Journal of Pain and Symptom Management

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“…Increased doses of Somatulin might have overcome this problem, although acromegalic patients had persistent and effective GH reduction by less frequent administration of the same dose (14). Development of resistance to SMS by receptor adaptation (desensitization) (24,25) is supported by the lack of a long-term persistent beneficial effect in our study and in a study on diabetic retinopathy (26).…”

Section: Conclusion-mentioning

confidence: 56%