Role of Vasoactive Drugs in the Treatment of Bleeding Oesophageal Varices

Goulis, John; Burroughs, Andrew K.

doi:10.1159/000051486

Cited by 20 publications

(7 citation statements)

References 39 publications

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“…From our results, it is not clear why somatostatin and octreotide have different haemodynamic effects in patients with cirrhosis (5, 23). One explanation could be the intrahepatic SSTR expression.…”

Section: Discussionmentioning

confidence: 71%

Expression of somatostatin receptors in splanchnic blood vessels of normal and cirrhotic rats

Reynaert

Rossen

Uyama

et al. 2007

Liver International

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Section: Discussionmentioning

confidence: 71%

Expression of somatostatin receptors in splanchnic blood vessels of normal and cirrhotic rats

Reynaert

Rossen

Uyama

et al. 2007

Liver International

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“…У јединој студији октреотид vs. плацебо није доказан никакав бенефит од терапије октреотидом као иницијалним третманом (26). Међутим, многе студије пратиле су ефекат октреотида као додатног третмана уз ендоскопску терапију.…”

Section: октреотидunclassified

The use of somatostatin and octreotide in the treatment of gastrointestinal bleeding

Mijailović¹

2013

Medicinski casopis

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УВОДКрварења из гастроинтестиналног тракта представљају изузетно озбиљна и ургентна стања у клиничкој пракси. Узроци крварења су врло различити, а из дидактичких разлога ова крварења подељена су на крварења из горњих и доњих делова гастроинтестиналног тракта. Акутна крварења из горњих делова гастроинтестиналног тракта (делови од усне дупље до Treitz-oвог лигамента) најчешћа су ургентна стања у гастроентерологији, сa морталитетом од 6-14%. Стопа инциденце показује широку географску варијацију у опсегу од 48 до 160 случајева на 100.000 становника, са већом инциденцом међу особама мушког пола и старијим особама (1).Узроци ових крварења су пептички улкуси (31%-67%), ерозије, езофагитиси, тумори, малигнитети, Маllоry-Weiss синдром и нешто ређе (2-8%) ретка стања као што су ангиодисплазије, хемобилија, вазоентеричне фистуле, гастричне антралне васкуларне лезије, Dieulafoy лезије (1). Посебан узрок акутних крварења из горњих делова гастроинтестиналог тракта представљају вариксна

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“…When compared with sclerotherapy, treatment with somatostatin and octreotide resulted in fewer side effects with equal efficacy 2 ,. 15 Finally, when combined with endoscopic therapy, somatostatin, octreotide and vapreotide proved to be more effective than placebo 2 ,. 16 No controlled trials assessing the effects of lanreotide or seglitide on bleeding varices have been published so far.…”

Section: Introductionmentioning

confidence: 99%

Pharmacological rationale for the use of somatostatin and analogues in portal hypertension

Reynaert

Geerts

2003

Aliment Pharmacol Ther

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SUMMARYSomatostatin and its analogue octreotide have been used for two decades to treat oesophageal variceal haemorrhage. The drug was introduced because of its capacity to decrease portal venous pressure without major side effects. In clinical trials assessing the efficacy of somatostatin and long-acting analogues in arresting variceal haemorrhage, conflicting results have been obtained. Furthermore, in haemodynamic studies evaluating the effects of somatostatin and analogues in patients with cirrhosis, divergent effects were observed. The main reason for these differences is probably related to different affinities of the drugs for different somatostatin receptor subtypes. The effects of somatostatin and analogues are mediated via five different G-protein coupled receptors (somatostatin receptor subtypes 1-5), which regulate the activity of ion channels (Ca 2+ , K + , Na + and Cl -) and enzymes (adenyl cyclase, phospholipase C, phospholipase A 2 , phosphoinositide 3-kinase and guanylate cyclase) responsible for the synthesis or degradation of intracellular second messengers including cyclic AMP, inositol 1,4,5-trisphosphate, diacylglycerol and cyclic GMP. Despite universal use of somatostatin, the cellular and biochemical mechanisms of its effects in portal hypertension are relatively poorly studied and remain incompletely understood. In this review, we summarize relevant signal transduction of somatostatin and analogues, the haemodynamic effects of the drugs and the possible mechanisms by which these effects are mediated.

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Role of Vasoactive Drugs in the Treatment of Bleeding Oesophageal Varices

Cited by 20 publications

References 39 publications

Expression of somatostatin receptors in splanchnic blood vessels of normal and cirrhotic rats

Expression of somatostatin receptors in splanchnic blood vessels of normal and cirrhotic rats

The use of somatostatin and octreotide in the treatment of gastrointestinal bleeding

Pharmacological rationale for the use of somatostatin and analogues in portal hypertension

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