sandostatin AND laxative?

[sandygator, BSN, RN]

I am a relatively new (3 years) Hospice nurse but have nearly 40 yrs nursing under my belt. Enough to know how to research meds. It is my understanding that Octreotide reduces both bowel motility and production of secretions and we use it to decrease pain associated with bowel obstruction. It seems to me that administering laxatives concurrently would be contraindicated. Can't seem to get a satisfactory answer from our MD. Wondering what your experiences have been with this?

[toomuchbaloney]

That seems to be an expensive drug choice for that treatment plan.

You are correct that gut stimulants would be contraindicated in cases of obstruction.

[TiffyRN, BSN, PhD]

There are many indications for octreotide; approved and off-label. Do a little searching and I bet you'll find your patient's indication. Or try asking the MD as there are so many diverse indications.

One of the most common reasons I used to see it given was for fistulas; pancreatic after prolonged pancreatitis or even rectal/intestinal. Mind you it's been 11 years since I worked with adults. In neonates we use it for a rare condition called Chylothorax.

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[pharmnerd]

It actually depends on a couple of different factors.

Sandostatin can be used for partial bowel obstruction or carcinoid syndrome, or fulminant, malignant diarrhea, but is not classified as carcinoid syndrome. with diarrhea, the laxative would not be given in any case. With partial bowel obstruction, I would not use a more laxative type agent, such as senna or bisacodyl. However, using more stool softening agents may be warranted to keep things going. Prokinetic agents' use in partial bowel obstruction (such as Reglan) is controversial, but as long as no complete obstruction, it may benefit the patient. If colic occurs, you would know the obstruction is significant and agents such as Senna, bisacodyl and metoclopramide should be avoided.