Pharmacologic Prevention of Rebleeding

Nader, Alexandre K.; Grace, Norman D.

doi:10.1016/s1052-5157(18)30209-5

Cited by 3 publications

(5 citation statements)

References 23 publications

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“…A meta-analysis of these trials reported a significant benefit for combination therapy with respect to rebleeding rates but failed to demonstrate a survival advantage [26]. However, many of these studies discontinued beta-blocker therapy after varices were eradicated endoscopically, making it impossible to assess a possible benefit of pharmacologic therapy over the long term.…”

Section: Secondary Prevention Of Variceal Hemorrhagementioning

confidence: 99%

Pharmacologic therapy for portal hypertension

Lowe

Grace

2001

Curr Gastroenterol Rep

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Pharmacologic therapy for portal hypertension is effective in the treatment and prevention of hemorrhage from esophagogastric varices. Acute hemorrhage from varices can be treated with intravenous agents such as somatostatin or terlipressin, either alone or in combination with endoscopic sclerotherapy or band ligation. Intravenous octreotide has not shown effectiveness as monotherapy, but it appears to be beneficial when combined with endoscopic treatment. The prevention of rebleeding after initial hemorrhage is best accomplished with non-selective beta blockers, endoscopic band ligation of varices, or a combination of endoscopic and pharmacologic therapies. The addition of oral nitrates may further decrease rebleeding rates, but more data from randomized trials are needed. Beta blockers are currently the only agents recommended for the primary prevention of variceal hemorrhage.

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Section: Secondary Prevention Of Variceal Hemorrhagementioning

confidence: 99%

Pharmacologic therapy for portal hypertension

Lowe

Grace

2001

Curr Gastroenterol Rep

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“…Medications, in particular the β-blockers, are also used to prevent longer-term bleeding since rebleeding rates of up to 80% within two years have been reported when no therapy is employed. 6 The use of prophylactic therapy for preventing long-term rebleeding is beyond the scope of this article, and the reader is referred to other published reviews. 1,6 The results of randomized trials involving vasopressin (with and without nitroglycerin), glypressin, and somatostatin for acute variceal bleeding have been reviewed, and a few generalizations can be made.…”

Section: Traditional Medications Used For Acute Variceal Bleedingmentioning

confidence: 99%

“…6 The use of prophylactic therapy for preventing long-term rebleeding is beyond the scope of this article, and the reader is referred to other published reviews. 1,6 The results of randomized trials involving vasopressin (with and without nitroglycerin), glypressin, and somatostatin for acute variceal bleeding have been reviewed, and a few generalizations can be made. 1 Perhaps the most important point concerns the number of patients enrolled in the trials.…”

Section: Traditional Medications Used For Acute Variceal Bleedingmentioning

confidence: 99%

Octreotide for Acute Variceal Bleeding

Erstad

2001

Ann Pharmacother

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“…It inhibits most gastrointestinal hormones and reduces gastrointestinal secretions and motility to treat diarrhoea and vomiting. It also reduces splanchnic blood flow and is useful in portal hypertension with oesophageal variceal bleeding 1 . Octreotide can reduce hormone secretion from gastrointestinal tract (GIT) tumours, 2 such as carcinoids, and can control acromegaly.…”

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confidence: 99%

“…It also reduces splanchnic blood flow and is useful in portal hypertension with oesophageal variceal bleeding. 1 Octreotide can reduce hormone secretion from gastrointestinal tract (GIT) tumours, 2 such as carcinoids, and can control acromegaly. There are case reports of phaeochromocytomas reducing in size with octreotide.…”

mentioning

confidence: 99%