Review Topic
  • A 50-year-old woman presents to her dermatologist for a rash of 1 week duration. She is noted to have erosions with crusting of the advancing edge, glossitis, and angular cheilitis. Her dermatologist notes that this rash is consistent with necrolytic migratory erythema, a condition seen in patients with glucagonomas. On laboratory evaluation, the patient has hyperglycemia and increased levels of glucagon. She is referred to oncology and started on octreotide.
  • Drugs
    • octreotide
  • Mechanism of action
    • octreotide is a somatostatin analog
      • inhibits secretion of splanchnic vasodilatory hormones
        • growth hormone
        • gastrin
        • vasoactive intestinal peptide (VIP)
        • glucagon
        • secretin
        • serotonin
        • pancreatic polypeptide
  • Clinical use
    • acute variceal bleeds
    • acromegaly
    • VIPoma
    • carcinoid tumors
    • glucagonoma
    • other neuroendocrine tumors
  • Adverse effects
    • gastrointestinal upset
    • steatorrhea
    • inhibits cholecystokinin, which increases the risk of cholelithiasis and cholecystitis
    • bradycardia

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