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Secretin

Pronouncation: (SEH-kreh-tin)
Class: GI function test

Trade Names:
SecreFlo
- Powder for injection, lyophilized 16 mcg of purified secretin

Mechanism of Action

Pharmacology

Increase the volume and bicarbonate content of secreted pancreatic juices.

Pharmacokinetics

Distribution

Vd approximately 2 L.

Elimination

After IV bolus administration of 0.4 mcg/kg, plasma concentration rapidly declines to baseline secretin levels within 90 min. Elimination t _½ 27 min.

Indications and Usage

Stimulation of pancreatic secretions, including bicarbonate, to aid in diagnosis of pancreatic exocrine dysfunction; stimulation of gastrin secretion to aid in diagnosis of gastrinoma; stimulation of pancreatic secretions to facilitate the identification of ampulla of Vater and accessory papilla during endoscopic retrograde cholangiopancreatography.

Contraindications

Acute pancreatitis.

Dosage and Administration

Stimulation of Gastrin Secretion
Adults

IV 0.4 mcg/kg over 1 min.

Stimulate Pancreatic Secretions; Facilitation of Identification of Ampulla of Vater
Adults

IV 0.2 mcg/kg over 1 min.

General Advice

For IV administration only. Not for intradermal, SC, IM, or intra-arterial administration.
Reconstitute powder using 8 mL sodium chloride injection following manufacturer"s instructions. Shake vigorously to dissolve. Each mL of reconstituted solution contains 2 mcg of secretin.
Use immediately after reconstitution. Discard any unused portion.

Storage/Stability

Store vials in freezer (-4°F).

Drug Interactions

Anticholinergics

May make patient hyporesponsive, producing false positive results.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Decreased BP (6%); mild bradycardia (2%); thready pulse (1%).

CNS

Lightheadedness (3%); headache, numbness/tingling in extremities (2%); fatigue, seizure (1%).

Dermatologic

Diaphoresis, flushing (6%); pallor, abdominal rash, urticaria secondary to contrast media (1%).

GI

Nausea (8%); abdominal discomfort (7%); burning in stomach (3%); abdominal cramps (2%); diarrhea, hunger pangs, vomiting (1%).

Miscellaneous

Sphincterectomy bleeding (6%); upper GI bleeding secondary to endoscopic abrasion, endoscopic perforation of pancreatic duct, transient respiratory distress (2%); bloating, fever, hot sensation, leukocytoclastic vasculitis, transient low oxygen saturation (1%).

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Acute pancreatitis

Do not administer to patient with acute pancreatitis until the episode has resolved.

Allergy

Because of potential allergic reaction, patients should receive an IV test dose of 0.2 mcg (0.1 mL).

Patient Information

Explain name, action, potential side effects of drug, and how drug will be used during the specific procedure that is going to be performed.
Advise patient that medication will be prepared and administered by a health care provider in a medical setting.

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