Octreotide
1
Reactions 578 - 25 Nov 1995 Octreotide Elevated serum zinc levels: case report Elevated serum zinc levels were seen in an 18-year-old boy after he received octreotide and concomitant parenteral nutrition that contained zinc. The boy had undergone small bowel resection following the accidental ingestion of ethylene glycol. On hospital day 17, therapy was started with SC octreotide 50µg three times daily, increased to 100µg three times daily after 3 days, to try and reduce his jejunostomy output. The results of routine tests showed his serum zinc levels to be in excess of the reference range. His zinc input (38 µmol/24h) was solely from parenteral nutrition and was within the recommended guidelines. The results of output studies suggested that the increase in serum zinc levels was due to reduced gastric secretion of zinc. When zinc was not included in the patient’s parenteral nutrition his serum zinc levels fell, but the fall was not sustained. 56 days after the start of octreotide therapy, the dosage was decreased to 100µg twice daily. Over the next 2 weeks, the patient’s serum zinc levels fell without an increase in his jejunostomy effluent. The dosage of octreotide was then reduced to 50 µg twice daily and then stopped. It was subsequently possible to include zinc in the patient’s parenteral nutrition. Author comment: ‘We hypothesised that prolonged therapy with octreotide in this patient inhibited gastrointestinal losses of zinc which was unable to be adequately compensated for and resulted in raised serum zinc concentrations.’ Ludington JE, et al. Octreotide associated with raised serum zinc concentrations - a case report. Australian Journal of Hospital Pharmacy 25: 422-423, Oct 1995 - Australia 800401322 1 Reactions 25 Nov 1995 No. 578 0114-9954/10/0578-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Octreotide
Reactions 578 - 25 Nov 1995
Octreotide
Elevated serum zinc levels: case reportElevated serum zinc levels were seen in an 18-year-old boy
after he received octreotide and concomitant parenteralnutrition that contained zinc.
The boy had undergone small bowel resection following theaccidental ingestion of ethylene glycol. On hospital day 17,therapy was started with SC octreotide 50µg three times daily,increased to 100µg three times daily after 3 days, to try andreduce his jejunostomy output. The results of routine testsshowed his serum zinc levels to be in excess of the referencerange. His zinc input (38 µmol/24h) was solely from parenteralnutrition and was within the recommended guidelines. Theresults of output studies suggested that the increase in serumzinc levels was due to reduced gastric secretion of zinc.
When zinc was not included in the patient’s parenteralnutrition his serum zinc levels fell, but the fall was notsustained. 56 days after the start of octreotide therapy, thedosage was decreased to 100µg twice daily. Over the next 2weeks, the patient’s serum zinc levels fell without an increasein his jejunostomy effluent. The dosage of octreotide was thenreduced to 50 µg twice daily and then stopped. It wassubsequently possible to include zinc in the patient’sparenteral nutrition.
Author comment: ‘We hypothesised that prolonged therapywith octreotide in this patient inhibited gastrointestinal lossesof zinc which was unable to be adequately compensated forand resulted in raised serum zinc concentrations.’Ludington JE, et al. Octreotide associated with raised serum zinc concentrations - acase report. Australian Journal of Hospital Pharmacy 25: 422-423, Oct 1995 -Australia 800401322
1
Reactions 25 Nov 1995 No. 5780114-9954/10/0578-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
