Acute GI hemorrhage resulting from gastric or duodenal ulcers, hemorrhagic gastritis & bleeding esophageal varices. Intestinal & pancreatic fistulae. Symptomatic treatment of excessive secretion from GIT endocrine tumors. Prevention of complications after pancreatic surgery or endoscopic retrograde cholangiopancreatography (ERCP).
Adult 3.5 mcg/kg/hr; 75 kg patient 6 mg/24 hr as continuous infusion of 250 mcg/hr; may be adjusted for 12 or 24 hr (3 or 6 mg respectively). GI hemorrhage Initiate infusion before endoscopy as soon as possible after the 1st signs of bleeding & continue for 5 days w/ min duration of 48 hr. Additionally, a 3.5 mcg/kg bolus inj should be given immediately after the start of continuous infusion & another bolus about 1 min before endoscopy given slowly (at least 1 min). Fistulae or excessive secretion from endocrine tumors Infuse ½ the dose for the next 48 hr after healing to avoid possible rebound effect. Severe renal failure (CrCl ≤30 mL/min) 1.75 mcg/kg/hr for continuous infusion & 1.75 mcg/kg for bolus.
Intended for hospital use & should be kept under strict medical observation. May induce transient systemic HTN & reduced cardiac output, increased pulmonary arterial pressure, & central venous pressure, systemic hypotension, bradycardia, & AV block. Patients w/ compromised CV status or history of cardiac arrhythmia. May inhibit intestinal absorption of certain nutrients & other GI hormone secretions. Simultaneous administration of any form of sugar. Hypoglycemia may occur at the beginning of infusion; measure blood sugar every 4-6 hr. Regularly check renal function & plasma electrolytes. Not recommended for adolescents & childn. Pregnancy. Not to be used during lactation. Elderly.
Drugs that influence blood glucose regulation, plasma renin level & arterial BP. May cause glycemic disturbances w/ any form of sugar (including glucose & fructose soln or TPN).
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