@emh1214 I would be happy to share. The desensitization process was done in conjunction with my oncologist in NC and my endocrinologist and allergist @ Mayo. They worked together on a protocol. I was admitted to the ICU for the procedure. The note below from my stay best describes the process and response:
Admitted to
the hospital for octreotide
desensitization for treatment of her recurrent, severe
hypoglycemia secondary to insulinoma. arrived to
hospital in the evening of and decision was to
hold initiation of her Octreotide desensitization until
the morning in case she had a severe reaction. On
Octreotide 1 mcg IV over 30 minutes was
initiated with pre-medications. She began having
tachycardia within 5 minutes of infusion thus it was
held. Her heart rate became normal and she was
asymptomatic. She was given Dexamethasone 20 mg
then infusion was re-initiated 5 minutes later. She
tolerated her first-third (1 mcg, 5 mcg and 10 mcg
doses) bags of Octreotide however during her third
infusion, she began experiencing "throat tightness,"
shortness of breath and rash. She informed the nurse
upon completion of Octreotide 10 mcg and was given
additional Famotidine and Benadryl. Evaluated patient
one hour after reaction, she was sitting up in bed and
eating her lunch. Was not having any difficulty
swallowing, shortness of breath or evidence of
rash/itching. States that she did not have any
associated wheezing with her SOB. Vital signs during
assessment were stable with no tachycardia and no
hypotension. Lungs were clear to auscultation with no
wheezing or diminished breath sounds. Discussed
with patient's primary oncologist. Gave Ativan 1 mg IV
then repeated Octreotide 10 mcg over one hour. Then
proceeded with remainder of Octreotide doses (bags
20 mcg and 40 mcg) however increase infusion time
from 30 minutes to 1 hour. Patient tolerated treatment
well noting only a 2/10 chest pain after completion of
the Octreotide 40 mcg. She was given Octreotide 50
mcg subcutaneous approximately 2.5 hours after
completed of the Octreotide 40 mcg infusion.
Early am on 12/08, patient had slight facial and neck
flushing. She was treated with Benadryl 20 mg and
Famotidine 20 mg with resolution.
Patient continued to do well and had no further
reactions. She was started on Octreotide 50 mcg
subcutaneous TID and received her first dose
inpatient. After a fwe hours of supervision, she had no
other symptoms and was discharged home with premedication,
Hope this is helpful! Best wishes!