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Pharmacology, clinical efficacy and safety of terlipressin in esophageal varices bleeding, septic shock and hepatorenal syndrome.

Abstract

Terlipressin, a vasopressin agonist, is a commonly used drug with different indications, particularly in patients with end-stage liver disease. As a V(1) receptor agonist, it increases systemic vascular resistance, particularly in the splanchnic area, resulting in a decrease of portal pressure. Besides the approved use for variceal bleeding, terlipressin also has beneficial effects in the treatment of hepatorenal syndrome and norepinephrine-resistant septic shock. In patients with cirrhosis and variceal bleeding, the use of terlipressin reduces the portal vein pressure and decreases the pressure in esophageal varices. This can save lives when skilled endoscopists are not immediately available. Hepatorenal syndrome is associated with vasodilation in the mesenteric circulation with arterial underfilling and consecutive renal vasoconstriction. Restoration of an effective arterial blood volume can be achieved by the combination of terlipressin and volume expansion. In some cases, a success rate of up to 75% is reported. The early use of terlipressin in catecholamine-resistant shock can improve organ perfusion.

Authors+Show Affiliations

University Essen, Department of General, Visceral and Transplant Surgery, Hufelandstr. 55, 45122 Essen, Germany. fuat.saner@uni-due.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19072411

Citation

Saner, Fuat H., et al. "Pharmacology, Clinical Efficacy and Safety of Terlipressin in Esophageal Varices Bleeding, Septic Shock and Hepatorenal Syndrome." Expert Review of Gastroenterology & Hepatology, vol. 1, no. 2, 2007, pp. 207-17.
Saner FH, Canbay A, Gerken G, et al. Pharmacology, clinical efficacy and safety of terlipressin in esophageal varices bleeding, septic shock and hepatorenal syndrome. Expert Rev Gastroenterol Hepatol. 2007;1(2):207-17.
Saner, F. H., Canbay, A., Gerken, G., & Broelsch, C. E. (2007). Pharmacology, clinical efficacy and safety of terlipressin in esophageal varices bleeding, septic shock and hepatorenal syndrome. Expert Review of Gastroenterology & Hepatology, 1(2), pp. 207-17. doi:10.1586/17474124.1.2.207.
Saner FH, et al. Pharmacology, Clinical Efficacy and Safety of Terlipressin in Esophageal Varices Bleeding, Septic Shock and Hepatorenal Syndrome. Expert Rev Gastroenterol Hepatol. 2007;1(2):207-17. PubMed PMID: 19072411.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacology, clinical efficacy and safety of terlipressin in esophageal varices bleeding, septic shock and hepatorenal syndrome. AU - Saner,Fuat H, AU - Canbay,Ali, AU - Gerken,Guido, AU - Broelsch,Christoph E, PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/3/6/medline SP - 207 EP - 17 JF - Expert review of gastroenterology & hepatology JO - Expert Rev Gastroenterol Hepatol VL - 1 IS - 2 N2 - Terlipressin, a vasopressin agonist, is a commonly used drug with different indications, particularly in patients with end-stage liver disease. As a V(1) receptor agonist, it increases systemic vascular resistance, particularly in the splanchnic area, resulting in a decrease of portal pressure. Besides the approved use for variceal bleeding, terlipressin also has beneficial effects in the treatment of hepatorenal syndrome and norepinephrine-resistant septic shock. In patients with cirrhosis and variceal bleeding, the use of terlipressin reduces the portal vein pressure and decreases the pressure in esophageal varices. This can save lives when skilled endoscopists are not immediately available. Hepatorenal syndrome is associated with vasodilation in the mesenteric circulation with arterial underfilling and consecutive renal vasoconstriction. Restoration of an effective arterial blood volume can be achieved by the combination of terlipressin and volume expansion. In some cases, a success rate of up to 75% is reported. The early use of terlipressin in catecholamine-resistant shock can improve organ perfusion. SN - 1747-4132 UR - https://www.unboundmedicine.com/medline/citation/19072411/Pharmacology_clinical_efficacy_and_safety_of_terlipressin_in_esophageal_varices_bleeding_septic_shock_and_hepatorenal_syndrome_ L2 - http://www.tandfonline.com/doi/full/10.1586/17474124.1.2.207 DB - PRIME DP - Unbound Medicine ER -