Why is octreotide given in esophageal varices?
Octreotide is frequently used in the ED for patients with a history of cirrhosis who present with a moderate or severe upper GI bleed presumed to be from a variceal source. Octreotide inhibits the release of glucagon, which is a splanchnic vasodilator.
How does octreotide help portal hypertension?
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.
How long does octreotide drip last?
The recommended duration of octreotide therapy is based largely on expert opinion, however a 72-hour duration of treatment is likely to be unnecessary and may inappropriately increase hospital and medical costs.
How does octreotide stop variceal bleeding?
It inhibits the release of many endocrine peptides including insulin and glucagon. In addition, it inhibits the release of gastric acid. Because glucagon is a vasodilator, octreotide indirectly decreases splanchic blood flow by its action inhibiting the release of glucagon.
Why is vasopressin given to patients with bleeding from esophageal varices?
Vasopressin has been used for 25 years to control bleeding from esophageal varices. Its efficacy is believed to be due to a direct vasoconstrictor activity on splanchnic arterioles and precapillary sphincters, with secondary reduction in portal venous blood flow and pressure.
What is an octreotide drip used for?
Octreotide injection is used to treat severe diarrhea and other symptoms that occur with certain intestinal tumors (eg, vasoactive intestinal peptide tumors or VIPomas) or metastatic carcinoid tumors (tumors that has already spread in the body).
Which beta-blocker is best for portal hypertension?
Propranolol is a noncardioselective beta-blocker that reduces portal pressure through the reduction of portal and collateral blood flow.
Which of the following drugs reduce portal pressure in patients with portal hypertension except?
Medications such as propranolol and isosorbide may be prescribed to lower the pressure in the portal vein and reduce the risk of recurrent bleeding. The drug lactulose can help treat confusion and other mental changes associated with encephalopathy.
What is Octreoscan used for?
An octreotide scan is used to detect and monitor treatment of neuroendocrine tumours, which arise from cells that produce hormones that are carried in the bloodstream. Many of these tumours are benign (non-cancerous), but some are malignant and can spread around the body.
Can octreotide be given IV?
Octreotide may be administered directly by subcutaneous (s.c.) injection or by intravenous (i.v.) infusion after dilution.
Why is propranolol used for esophageal varices?
By slowing the heart rate and widening the blood vessels, beta-blocker medicines such as propranolol and nadolol appear to lower the blood pressure in varices that bypass the liver. In people who have esophageal varices, beta-blockers have been shown to reduce the risk of having a first episode of bleeding.
Is vasopressin used to treat esophageal varices?
Vasopressin is widely used in treatment of hemorrhage from esophageal varices either as a systemic intravenous or superior mesenteric arterial infusion; variceal bleeding is controlled in about 50 to 60% of patients (1-8).