Terlipressin and octreotide in the treatment of acute bleeding Biology essay
Abstract. Upper gastrointestinal bleeding is a common emergency requiring immediate resuscitation and treatment. Stomach ulcers are the most common cause of the condition. Thorough initial treatment with a structured approach is vital, with appropriate intravenous fluid resuscitation and use of a restrictive transfusion. Acute variceal bleeding should be suspected in all patients with cirrhosis who present with upper gastrointestinal bleeding. Vasoactive drugs and prophylactic antibiotics should be started as soon as possible, even before performing the diagnostic endoscopy. Once the patient is hemodynamically stable, in the upper gastrointestinal tract, our study shows that treatment with terlipressin is non-inferior. Treatment with terlipressin in acute EVB, as adjunctive therapy to successful EVBL. To our knowledge, for the first time, in a double-blind study, we have demonstrated the efficacy of an ultra-short course compared with treatment with terlipressin as adjuvant therapy in the number of patients who survived after five days. without rebleeding was higher in the octreotide group, 85 patients, percent than in the placebo group 72, conclusions. Acute esophageal VH treatment should include optimal resuscitation, effective preendoscopic and postendoscopic medical therapy, and timely endoscopic intervention. EVL effectively treats active bleeding, but does not treat the most common cause, portal hypertension. Treatment with Octreotide is initiated in patients with acute variceal bleeding, severe liver disease, a history of variceal bleeding, a history of alcoholism or altered biochemical parameters in the liver. . Octreotide replaced vasopressin as pharmacotherapy for variceal bleeding due to uncommon and less serious side effects,72 Rennyson et al. described a patient with HeartMate II who presented with recurrent gastrointestinal bleeding, who was initially treated with µg SC octreotide and subsequently discharged home discharged with intramuscular IM, depot of octreotide. He responded with a reduced frequency of gastrointestinal bleeding and a reduced need for subsequent transfusions. Since then, several studies have also confirmed the efficacy of terlipressin in cirrhotic patients with acute variceal bleeding. 27,29, a meta-analysis of RCT cases compared the efficacy and safety of terlipressin versus placebo, pituitrin, somatostatin, octreotide, endoscopic therapy or balloon tamponade for the, Objective: To compare the efficacy of octreotide versus terlipressin in preventing the primary outcome of weeks mortality, days with rebleeding as a secondary outcome in acute esophageal varices. Octreotide acts as a synthetic somatostatin analogue and reduces blood flow to the gastrointestinal tract. Chan et al. (86) reported that octreotide could decrease endothelial nitric oxide levels, thereby inhibiting the release of glucagon, a potent vasodilator, leading to splanchnic vasoconstriction and reduced bleeding. Small studies have suggested that vasoactive drugs such as octreotide and terlipressin may be useful for controlling acute bleeding. Pan s et al. 1994 Kouroumalis et al. 1998 Zhou et al. 2002. The treatment of acute variceal bleeding has improved greatly in recent years. The available data show that the general treatment of the bleeding cirrhotic patient by an experienced multidisciplinary team is a.,