sandostatin injection times

[clemmm78, RN]

I need some comments regarding admin of sandostatin (octreotide injection), not the long-acting.

If you give it in your workplace, what times is it usually given? We are having a debate in our palliative care. The day nurses schedule the a.m. dose for 6 a.m. but some of the night nurses are reluctant to wake patients for this one med if there are no others, so they would prefer to see it changed to 8 a.m., when there is a much higher likelihood of the patient being awake.

Thanks,

[ginger58, ASN, RN]

We usually give it between 09 and 1400. I definitely wouldn't wake someone up to give most anything.

[Rabid Badger, BSN, RN]

I would not wake a palliative patient at 6 am. Especially for a injection that could be easily scheduled later without undue harm or side effects to the patient.

[clemmm78, RN]

Thank you to both of you for responding. This is a running battle the night staff is having with the day staff. They are insisting that it is vital that the patient receive it to fight of early am nausea symptoms in combination with early PRN Gravol (dimenihydrinate) but they are *sleeping*. Morning care only begins when they wake up. They set their own schedules.

I'm very frustrated.

[Rabid Badger, BSN, RN]

Why can't you give it sc via a sc line to avoid waking and poking the patient?

[clemmm78, RN]

we do give it that way. But 9 times out of 10, the patient wakes up because we have to get to the butterfly which is on the arm, the chest or the leg.

[Rabid Badger, BSN, RN]

Well honestly in that case I would give it at 6 am, so the patient does not wake up for washing/breakfast/etc nauseated. Its a bit different to wake a palliative patient at 6 am for a poke versus a slight touch of the hand, gentle awakening and soothing back to sleep as you give a med via sc line. When I give abx at 6 am, 99% of the time the patient rouses enough to see that I am an there and am not the boogeyman, and they fall back to sleep.

I think in this case the beneifts of giving the med early outweigh the cons.

[clemmm78, RN]

I understand your point, however, morning care in our place begins *late*. Even if they were woken at 8, they still would have plenty of time for washing up, breakfast, whatever. baths, are never done before breakfast, and breakfast is whenever the patient wants it, starting only at 9:30.

[Rabid Badger, BSN, RN]

I guess what I am saying is that as a patient, I'd rather be accidentally woken at 6 am to be given my anti-nausea meds in a non-painful manner than to wake up on my own at 8 feeling nauseated and heaving. My need to be nausea free is more important to me than possibly being woken by someone accessing my line. Therefore the benefits outweigh the cons to me as a patient. And so that is how I would approach the situation as the nurse.

[clemmm78, RN]

Point is taken. Thanks. That's why I asked!

[Rabid Badger, BSN, RN]

No problem. Hope that was helpful.

[ginger58, ASN, RN]

Marijke, Don't back off so fast. Here's the peak, half life, etc. I found:

The elimination of octreotide from plasma had an apparent half-life of 1.7 to 1.9 hours compared with 1-3 minutes with the natural hormone. The duration of action of SandostatinÒ (octreotide acetate) is variable but extends up to 12 hours depending upon the type of tumor. About 32% of the dose is excreted unchanged into the urine. In an elderly population, dose adjustments may be necessary due to a significant increase in the half-life (46%) and a significant decrease in the clearance (26%) of the drug."

So, it's quick acting, has a T1/2 of