Snapshot 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. Introduction 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