Document Detail


Pharmacologic therapy for gastrointestinal bleeding due to portal hypertension and esophageal varices.
MedLine Citation:
PMID:  16510029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cirrhosis results in portal hypertension in many patients. The major complications of portal hypertension include development of ascites and esophageal or gastric varices. Varices lead to hemorrhage and death in a significant proportion of patients. This review focuses on the pharmacologic approach to management of portal hypertension in patients at risk of variceal hemorrhage, or those who have already had variceal bleeding. Pharmacologic therapy is used for 1) primary prevention of bleeding, 2) management of acute bleeding, and 3) prevention of recurrent bleeding (secondary prophylaxis). For acute esophageal variceal hemorrhage, a variety of pharmacologic agents are used, including somatostatin, octreotide, vapreotide, lanreotide, terlipressin, and vasopressin (with nitrates). For primary and secondary prevention of esophageal variceal hemorrhage, beta-blockers remain the mainstay therapy.
Authors:
Don C Rockey
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current gastroenterology reports     Volume:  8     ISSN:  1522-8037     ISO Abbreviation:  Curr Gastroenterol Rep     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-03-02     Completed Date:  2006-06-20     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  100888896     Medline TA:  Curr Gastroenterol Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  7-13     Citation Subset:  IM    
Affiliation:
Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8887, USA. don.rockey@usouthwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Algorithms
Antihypertensive Agents / therapeutic use
Cardiovascular Agents / therapeutic use*
Esophageal and Gastric Varices / etiology*
Esophagoscopy
Gastrointestinal Hemorrhage / drug therapy*,  etiology,  therapy
Hemostatics / therapeutic use
Humans
Hypertension, Portal / drug therapy*,  etiology,  physiopathology,  therapy
Ligation
Liver Cirrhosis / complications
Nitrates / therapeutic use
Portasystemic Shunt, Transjugular Intrahepatic
Recurrence
Sclerotherapy
Somatostatin / therapeutic use
Vasoconstrictor Agents / therapeutic use
Vasopressins / therapeutic use
Grant Support
ID/Acronym/Agency:
R01 DK 50574/DK/NIDDK NIH HHS; R01 DK 57830/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents; 0/Cardiovascular Agents; 0/Hemostatics; 0/Nitrates; 0/Vasoconstrictor Agents; 11000-17-2/Vasopressins; 51110-01-1/Somatostatin

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


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