Symptomatic bradycardia or new arrhythmia — report immediately.
Before you read
Test yourself first: 1 question
Question 1 of 1
A client with bleeding esophageal varices is started on an octreotide infusion. The nurse explains that the primary purpose of this drug is to:
Answer: B. Octreotide, a somatostatin analog, reduces splanchnic and portal blood flow, which decreases pressure in the varices and helps control variceal bleeding. It does not directly promote clotting, neutralize gastric acid, or sedate the client. It is a first-line pharmacologic agent for acute variceal hemorrhage alongside endoscopic therapy.
Keep the streak going with more questions like these, each with a full rationale.
What is octreotide?
It is used for acromegaly, carcinoid and VIPoma tumor-related severe diarrhea and flushing, and to control bleeding esophageal varices by reducing splanchnic blood flow. Because it alters insulin and glucagon, it can disrupt blood glucose in either direction.
Key points to remember
- Synthetic somatostatin analog that suppresses growth hormone, glucagon, insulin, serotonin, and GI hormone secretion.
- Used for acromegaly, carcinoid syndrome and VIPoma (severe secretory diarrhea/flushing), and acute variceal bleeding.
- Can cause both hyperglycemia and hypoglycemia because it alters insulin and glucagon release; glucose monitoring is essential.
- Common side effects include gallstones/biliary sludge, nausea, abdominal cramps, and bradycardia.
- Available as short-acting subcutaneous/IV and a long-acting depot intramuscular form (LAR).
Nursing priorities
- Monitor blood glucose closely because the drug can cause hyper- or hypoglycemia.
- Assess for gallbladder problems (right upper quadrant pain, intolerance of fatty foods) with long-term use.
- Monitor heart rate for bradycardia and assess GI symptoms and fluid/electrolyte balance.
- Rotate subcutaneous injection sites and allow the solution to reach room temperature to reduce pain.
Labs & values
Patient teaching
- Check blood sugar as directed because levels can go high or low.
- Report right-upper belly pain, nausea after fatty meals, or yellowing skin.
- Rotate injection sites and let the medication warm to room temperature before injecting.
- Report a slow heartbeat, dizziness, or fainting.
- Keep follow-up appointments for gallbladder and hormone-level monitoring.
Red flags: report now
- Symptomatic bradycardia or new arrhythmia — report immediately.
- Right upper quadrant pain, fever, or jaundice — possible gallstones/cholecystitis; report now.
- Severe hypoglycemia or marked hyperglycemia — treat and report; do not ignore glucose swings.
References
Clinical references for this topic
