Document Detail


Acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis: a randomized comparison.
MedLine Citation:
PMID:  15743362     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Octreotide and terlipressin are widely used in acute variceal hemorrhage to reduce the bleeding rate. They purportedly act by mesenteric arterial vasoconstriction, thus reducing portal venous flow (PVF) and portal pressure. Little is known about the immediate-early hemodynamic effects of these drugs. AIM: To compare the acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis. PATIENTS: Forty-two cirrhotic patients with a history of variceal bleeding were randomized to receive either octreotide 100 microg intravenous bolus followed by a continuous infusion at 250 microg/h (n = 21), or terlipressin 2 mg intravenous bolus (n = 21). METHODS: Mean arterial pressure (MAP), heart rate (HR), hepatic venous pressure gradient (HVPG), and PVF, assessed by duplex Doppler ultrasonography, were measured before and at 1, 5, 10, 15, 20, and 25 min after the start of drug administration. RESULTS: Octreotide markedly decreased HVPG (-44.5 +/- 17.8%) and PVF (-30.6 +/- 13.6%) compared to the baseline at 1 min (p < 0.05). Thereafter, both variables rapidly returned toward the baseline, and by 5 min, no significant differences in HVPG (-7.1 +/- 28.9%) and PVF (10.2 +/- 26.2%) were noted. A similar transient effect on MAP and HR was observed. Terlipressin significantly decreased HVPG (-18.3 +/- 11.9%) and PVF (-32.6 +/- 10.5%) at 1 min (p < 0.05) and sustained these effects at all time points. The effects on arterial pressure and HR were also sustained. CONCLUSIONS: Octreotide only transiently reduced portal pressure and flow, whereas the effects of terlipressin were sustained. These results suggest that terlipressin may have more sustained hemodynamic effects in patients with bleeding varices.
Authors:
Soon Koo Baik; Phil Ho Jeong; Sang Won Ji; Byung Su Yoo; Hyun Soo Kim; Dong Ki Lee; Sang Ok Kwon; Young Ju Kim; Joong Wha Park; Sei Jin Chang; Samuel S Lee
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  100     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-03     Completed Date:  2005-04-22     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  631-5     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine,Yonsei University Wonju College of Medicine, Wonju, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / drug effects
Esophageal and Gastric Varices / drug therapy*,  physiopathology
Female
Gastrointestinal Agents / administration & dosage,  pharmacology*
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Injections, Intravenous
Liver Circulation / drug effects
Liver Cirrhosis / drug therapy*,  physiopathology
Lypressin / administration & dosage,  analogs & derivatives*,  pharmacology*
Male
Middle Aged
Octreotide / administration & dosage,  pharmacology*
Portal System / drug effects
Ultrasonography, Doppler, Duplex
Vasoconstrictor Agents / administration & dosage,  pharmacology*
Venous Pressure / drug effects
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents; 0/Vasoconstrictor Agents; 14636-12-5/terlipressin; 50-57-7/Lypressin; 83150-76-9/Octreotide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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