Secretin

Pronunciation: se-KREE-tin
Class: GI function test

Trade Names

ChiRhoStim
- Injection, lyophilized powder for solution 16 mcg
- Injection, lyophilized powder for solution 40 mcg

Pharmacology

Increase the volume and bicarbonate content of secreted pancreatic juices.

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Pharmacokinetics

Distribution

Vd is 2.7 L.

Elimination

Cl is 580.9 ± 51.3 mL/min. After IV bolus administration of 0.4 mcg/kg, plasma concentration rapidly declines to baseline secretin levels within 90 to 120 min. Elimination half-life is 45 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

IV 0.4 mcg/kg over 1 min.

IV 0.2 mcg/kg over 1 min.

General Advice

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

Storage/Stability

Store vials in freezer (−4°F). Protect from light.

Drug Interactions

May make patient hyporesponsive, producing false-positive results.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Hypotension, increased heart rate, slow heart rate.

CNS

Anxiety, faintness, sedation.

Dermatologic

Clammy skin, flushing.

GI

Diarrhea, increased oral secretions, mild pancreatitis, nausea, upset stomach, vomiting.

Miscellaneous

Abdominal pain, burning sensation in abdomen or stomach, decreased O ₂ saturation, early removal of Dreiling tube, tingling in legs, unresponsiveness, warm sensation in abdomen, warm sensation in face.

Precautions

Pregnancy

Undetermined .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Elderly

Differences in responses between elderly and younger patients have not been identified, but greater sensitivity cannot be ruled out.

Hepatic Function

Patients who have alcoholic or other liver disease may have a greater than normal volume response to secretin stimulation; interpret results of secretin stimulation tests with caution.

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).

Inflammatory bowel disease or vagotomy

Patients who have inflammatory bowel disease or who have undergone vagotomy may be hyporesponsive to secretin stimulation. This does not indicate pancreatic disease; interpret results of secretin stimulation tests with caution.

Overdosage

Symptoms

No data available.

Patient Information

• Explain name, action, and 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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