Synthetic octapeptide, which is a derivative of the natural hormone somatostatin, and has similar pharmacological effects to it, but much longer duration of action. Testosterone cypionate side effectsinhibits the secretion of growth hormone (GH), a pathologically increased, and caused by arginine, exercise and insulin-induced hypoglycemia. The drug also inhibits the secretion of insulin, glucagon, gastrin, serotonin is abnormally increased, and caused by eating food; also suppresses the secretion of insulin and glucagon stimulated arginine. Sandostatin suppresses the secretion of thyrotropin, induced by thyrotropin-releasing hormone. Unlike somatostatin, octreotide inhibits secretion to a greater extent than the secretion of insulin and its introduction is not accompanied by subsequent hypersecretion hormones (e.g. GH in patients with acromegaly).
In patients with acromegaly Sandostatin reduces the concentration and insulin-like growth factor in plasma. Reducing the concentration or more is observed in 90% of patients, with the value of concentrations less than 5 ng / ml is reached in about half of patients. The majority of patients with acromegaly Sandostatin® reduces the severity of the headache, swelling of soft tissues, hyperhidrosis, arthralgia and paraesthesia. In patients with large pituitary adenomas treatment Sandostatin may lead to some reduction in tumor size.
When secreting endocrine tumors of the gastrointestinal t and pancreas in the case of insufficient effectiveness of the therapy (surgery, hepatic artery embolization, chemotherapy, including streptozotocin and 5-fluorouracil) appointment of Sandostatin may result in improvement of the disease. Thus, with carcinoid tumors application Sandostatin may reduce the severity of sensations flares, diarrhea, which in many cases accompanied by a decrease in the plasma concentration of serotonin and 5-hydroxyindole excretion acid excretion. When tumors characterized by hyperproduction intestinalnogo vasoactive peptide. Testosterone cypionate side effects use in most patients results in a severe decrease in the secretory diarrhea and therefore improve the quality of life of the patient. At the same time there is a reduction of concomitant electrolyte imbalance, eg hypokalaemia, enabling enteral and parenteral cancel the introduction of fluids and electrolytes. In some patients, it slows or stops the progression of a tumor, there is a reduction of its size and the size of liver metastases. Clinical improvement is usually accompanied by decrease in the concentration of vasoactive intestinal peptide (VIP) in plasma or its normalization.
When Glucagonomas use of Sandostatin results in a reduction of erythema migrans. Does not have any significant effect on the severity of hyperglycemia in diabetes mellitus, while the need for insulin or oral hypoglycemic drugs usually remains unchanged. The drug causes a decrease in diarrhea, which is accompanied by an increase in body weight. Although the decline in glucagon concentration in blood plasma under the influence of Sandostatin is transient, clinical improvement remained stable during the entire period of the drug. In patients with gastrinomas / Zollinger-Ellison syndrome with Sandostatin use as monotherapy or in combination with proton pump inhibitors or blockers of H 2 receptors may reduce the hypersecretion of hydrochloric acid in the stomach, reducing the concentration of gastrin in the blood plasma, as well as reducing the severity of diarrhea and tidal . Patients with insulinomas Sandostatin reduces the level of immunoreactive insulin levels (this effect may be short – about 2 hours). In patients with operable tumors Sandostatin may provide restoration and maintenance of normoglycemia in the preoperative period. In patients with inoperable benign or malignant tumors, glycemic control may be improved without simultaneously prolonged decline in the level of insulin in the blood. In patients with rarely occurring tumors overproducing releasing factor growth hormone (somatoliberinomami) , testosterone cypionate side effects reduces the severity of symptoms of acromegaly. This is due to the suppression releasing factor secretion of growth hormone and growth hormone itself. In the future, may be reduced hypertrophy of the pituitary gland. Whenrefractory diarrhea in patients with acquired immunodeficiency syndrome (AIDS), the use of Sandostatin results in complete or partial normalization of stool in approximately 1/3 of patients suffering from diarrhea not controlled by adequate antimicrobial therapy and / or antidiarrheal agents. Do patients who planned to carry out operations on the pancreas, the use of Sandostatin during and after surgery reduces the incidence of typical postoperative complications (eg pancreatic fistula, abscess, sepsis, postoperative acute pancreatitis). If bleeding from varices of the esophagus and stomach in patients with cirrhosis liver use Sandostatin in combination with a specific treatment (for example, sclerosing therapy) results in a more effective early stopping bleeding and re-bleeding, transfusion volume reduction and improvement of the 5-day survival. It is believed that the mechanism of action of Sandostatin associated with reduced blood flow through the suppression of organ such as an VIP vasoactive hormones and glucagon.
After subcutaneous injection Sandostatin is rapidly and completely absorbed. Maximum plasma concentrations reached within 30 minutes. Distribution protein binding is 65%. Sandostatin binding to formed elements of blood is extremely low. The volume of distribution is 0.27 l / kg. Elimination half-life after s / c injection of the drug is 100 minutes. After the on / in the excretion of the drug is carried out in two phases, with half-lives of 10 and 90 min, respectively. Most of the drug is excreted in the faeces, approximately 32% – unchanged in the urine. Total clearance was 160 ml / min.