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Pharmacology · Endocrine drugs: octreotide adverse effects
Sample itemA man with acromegaly has been on long-acting octreotide for two years. He now has intermittent right upper quadrant pain after meals, and ultrasound shows echogenic foci with shadowing in the gallbladder. What explains this?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Reduced gallbladder motility from octreotide causing gallstones
Somatostatin analogues inhibit cholecystokinin release and gallbladder contraction, causing bile stasis and gallstones in a large proportion of long-term users. They can also cause steatorrhoea, bradycardia and glucose changes.
Option by option
A. Growth hormone excess causing stone dissolution
Growth hormone excess does not dissolve stones, and the drug is the likely cause.
B. Increased bile salt secretion leading to cholesterol dissolution
Octreotide lowers bile flow and does not increase bile salt secretion.
C. Reduced gallbladder motility from octreotide causing gallstones (correct)
Correct. Octreotide reduces gallbladder emptying and promotes stone formation.
D. Direct hepatotoxicity causing biliary sludge only in the liver
The change is in the gallbladder, not a primary hepatic injury.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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