Which medications in the drug class Hormones/Hormone Analogs are used in the treatment of Pediatric Gastrointestinal Bleeding?

Updated: Dec 19, 2018
  • Author: Wayne Wolfram, MD, MPH; Chief Editor: Robert K Minkes, MD, PhD  more...
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Answer

Hormones/Hormone Analogs

Pharmacologic treatment to reduce portal pressure is important for the treatment of bleeding from esophageal varices. Propranolol has been studied for primary and secondary prophylaxis of esophageal varices; although it is helpful for adults, studies in children are limited. Therefore, these drugs are not currently considered the standard of care for this population.

In addition, vasopressin had been used as a splanchnic vasoconstrictor, but its many adverse effects (eg, bowel-wall or cutaneous ischemia, hypertension, abdominal pain) have made it less desirable than other options are, even when tempered with the vasodilatory effects of nitroglycerin. As a result, octreotide has emerged as the recommended treatment, especially in conjunction with sclerotherapy for patients with variceal bleeding, because it blunts sudden increases in pressure due to postprandial hyperemia.

Octreotide (Sandostatin, Sandostatin LAR)

A synthetic polypeptide, octreotide acts as natural somatostatin but is more resistant to enzymatic degradation and has a longer half-life in circulation than somatostatin. These factors make octreotide easier to use clinically.

Vasopressin (Pitressin)

At high doses, vasopressin can cause vasoconstriction, with many other effects (eg, promoting water resorption, increasing peristaltic activity). It is effective in reducing portal pressure.


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