Potential incompatibility of insulin and octreotide in total parenteral nutrient solutions

Rosen, Gail H.

doi:10.1093/ajhp/46.6.1128

Cited by 3 publications

(1 citation statement)

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“…39 There is additional concern that octreotide could affect the activity of insulin when both are compounded into TPN, and vice versa. 41 There are no clinical trials that have verified these claims, but insulin and octreotide can affect one another in vivo. 41 For these reasons, we avoid mixing insulin and octreotide in TPN solutions.…”

Section: Formulationmentioning

confidence: 99%

Treatment of intestinal failure: home parenteral nutrition

Mullady

O'Keefe

2006

Nat Rev Gastroenterol Hepatol

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Intestinal failure can result from surgical resection, obstruction, dysmotility, congenital deficiencies or disease-associated loss of absorption. Before the development of intravenous feeding in the late 1960s, the condition was fatal, but by the 1990s approximately 40,000 patients were being successfully managed on long-term home parenteral nutrition (HPN) annually in the US. Survival on HPN depends on the nature of the underlying medical condition: over 80% of Crohn's disease patients survive for 5 years, but only 20% of cancer patients survive for 1 year. Although a patient's nutritional status is easy to maintain, there are serious long-term complications that arise from bypassing the gut and infusing nutrients directly into the systemic circulation. Catheter sepsis occurs about once per year (range 0-12 times). Abnormalities in liver function tests are common, but end-stage liver disease is rare. Central venous thrombosis develops in nearly all patients after 5 years. Although approximately 80% of patients on HPN are completely rehabilitated at home, their quality of life is impaired by the perpetual dependence on nocturnal intravenous infusions (every 8-12 h). In conclusion, HPN has allowed patients with previously fatal intestinal failure to survive and lead relatively normal lives at home, but their quality of life remains impaired by the dependence on intravenous infusions and complications that progress with time.

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Section: Formulationmentioning

confidence: 99%