Pharmacokinetics of octreotide in patients with cirrhosis and portal hypertension; relationship between the plasma levels of the analogue and the magnitude and duration of the reduction in corrected wedged hepatic venous pressure.

Document Detail

Pharmacokinetics of octreotide in patients with cirrhosis and portal hypertension; relationship between the plasma levels of the analogue and the magnitude and duration of the reduction in corrected wedged hepatic venous pressure.

Jump to Full Text
MedLine Citation:	PMID: 9830576 Owner: NLM Status: MEDLINE
Abstract/OtherAbstract:	In healthy subjects octreotide is largely metabolised by the liver suggesting that the plasma half-life of the somatostatin analogue may be prolonged in patients with hepatic dysfunction. The aim of this study was therefore (a) to determine the pharmacokinetics of octreotide following its subcutaneous injection in 6 patients with cirrhosis and portal hypertension and (b) compare the magnitude and duration of the effects of intravenous administration of 250 micrograms somatostatin and 50 micrograms octreotide on corrected wedged hepatic venous pressure (WHVP) and to relate the findings to the plasma levels of the analogue 1 h after administration in 13 patients with cirrhosis and portal hypertension. Following subcutaneous administration of 50 micrograms octreotide the circulating half life (range 2.4 to 4.79 h) was prolonged whereas the clearance (range 2.101 to 4.775 L/h) was decreased compared to healthy controls. Intravenous bolus administration of 250 micrograms somatostatin or 50 micrograms octreotide resulted in a reduction in WHVP of approximately the same magnitude and duration despite appreciable quantities of the analogue in the blood 1 h after administration (1944 +/- 226 pg/ml). These results indicate that the circulating half-life of octreotide is prolonged in cirrhotics suggesting that the dosage regimens should be modified in such patients to avoid accumulation of the analogue in the blood which may result in undesirable side-effects or toxicity. Furthermore, since the magnitude and duration of the reduction in WHVP elicited by IV octreotide is similar to that observed with somatostatin, the analogue, like the native hormone, must be administered by continuous IV infusion to produce a sustained response and hence a therapeutic effect in the management of acute variceal bleeding.

Authors:	S A Jenkins; D M Nott; J N Baxter
Related Documents :	1728676 - Myointimal thickening in experimental vein grafts is dependent on wall tension. 12657396 - Systemic and regional effects of supraceliac aortic occlusion during experimental hepat... 1427656 - Octreotide inhibits the meal-induced increases in the portal venous pressure of cirrhot... 1506656 - Hemodynamic effects of a combination of vasopressin and ketanserin in patients with hep... 8863946 - Clinical defense response to cold and noise in preterm neonates after intrauterine cond... 19581506 - Intensifying therapy for hypertension despite suboptimal adherence.
Publication Detail:	Type: Comparative Study; Journal Article
Journal Detail:	Title: HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Volume: 11 ISSN: 0894-8569 ISO Abbreviation: HPB Surg Publication Date: 1998
Date Detail:	Created Date: 1999-01-28 Completed Date: 1999-01-28 Revised Date: 2008-11-20
Medline Journal Info:	Nlm Unique ID: 9002972 Medline TA: HPB Surg Country: SWITZERLAND
Other Details:	Languages: eng Pagination: 13-21 Citation Subset: IM
Affiliation:	University Department of Surgery, Royal Liverpool University Hospital.
Export Citation:	APA/MLA Format Download EndNote Download BibTex
MeSH Terms
Descriptor/Qualifier:	Blood Pressure / drug effects* Female Half-Life Hepatic Veins / drug effects, physiopathology Hormones / administration & dosage, blood, pharmacokinetics, pharmacology Humans Hypertension, Portal / blood, drug therapy, physiopathology Injections, Intravenous Injections, Subcutaneous Liver Cirrhosis / blood, drug therapy, physiopathology Male Octreotide / administration & dosage, blood, pharmacokinetics*, pharmacology Somatostatin / administration & dosage, pharmacology Statistics, Nonparametric Time Factors
Chemical
Reg. No./Substance:	0/Hormones; 51110-01-1/Somatostatin; 83150-76-9/Octreotide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Full Text

Journal Information Journal ID (nlm-ta): HPB Surg ISSN: 0894-8569 ISSN: 1607-8462 Publisher: Hindawi Publishing Corporation	Article Information Download PDF Copyright ? 1998 Hindawi Publishing Corporation. open-access: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Accepted Day: 3 Month: 6 Year: 1997 Print publication date: Month: 8 Year: 1998 Volume: 11 Issue: 1 First Page: 13 Last Page: 21 ID: 2423925 PubMed Id: 9830576 Publisher Item Identifier: S0894856998174362 DOI: 10.1155/1998/17436


Pharmacokinetics of Octreotide in Patients With Cirrhosis and Portal Hypertension; Relationship Between the Plasma Levels of the Analogue and the Magnitude and Duration of the Reduction in Corrected Wedged Hepatic Venous Pressure
S. A. Jenkins12
D. M. Nott13
J. N. Baxter12
	1University Department of SurgeryRoyal Liverpool University HospitalLiverpoolL7 8XPUnited Kingdom
	2Department of SurgeryPostgraduate Medical SchoolMorriston HospitalSwanseaMorristonSA6 6NLUSA
	3Academic Department of SurgeryChelsea and Westminster HospitalLondonSW 10 9NHUnited Kingdom


Article Categories: Research Article

Previous Document: Carcinoma of the ampulla of vater: determinants of long-term survival in 94 resected patients.
Next Document: Spontaneous passage of gallbladder calculi--facilitation by endoscopic sphincterotomy.