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Pharmacologic Agents for Acute Variceal Bleeds? | Liver Disorders | #CodeBlueDebrief

Updated: Dec 12, 2023

Welcome to PHARMWYZE! Clinical pharmacotherapy content made for learners of all medicine backgrounds. Thanks for joining me on the Code Blue Debrief YouTube & Podcast series. The focus will be evidence-based medicine and pharmacotherapy topics for emergency medicine and critical care learners.

 


 

During my time as a COVID resident, I had an invaluable experience taking care of severely sick COVID and decompensated cirrhotic patients. Both patient populations are complex, requiring consistent, thorough patient workup. Acute variceal bleeds are a severe complication of cirrhosis. This can lead to hemmorhagic shock. Let's discuss medications used for acute variceal bleeds. I've shifted content development into longer formats and would love to hear your input! Please let me know your thoughts in the comments below.


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References

Smith A, Baumgartner K, & Bositis C. Cirrhosis: Diagnosis and Management. Am Fam Physician . 2019 Dec 15;100(12):759-770.

Yoshiji et al. Evidence-based clinical practice guidelines for Liver Cirrhosis 2020. J Gastroenterol . 2021 Jul;56(7):593-619.

Laine et al. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. Am J Gastroenterol . 2021 May 1;116(5):899-917.

Garcia-Tsao et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology . 2017 Jan;65(1):310-335. doi: 10.1002/hep.28906.

Sachar H, Vaidyta K, Laine L. Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis. JAMA Intern Med . 2014 Nov;174(11):1755-62.

Lau JY, Leung WK, Wu JC, et al. Omeprazole before endoscopy in patients with gastrointestinal bleeding. N Engl J Med 2007;356:1631–40.

Zia H, Aby E, Rabiee A. An Update on the Management of Esophageal Variceal Hemorrhage. Clin Liver Dis (Hoboken). 2021 Oct; 18(4): 179–183.

Garcia-Tsao G. Overview of Current Management of Portal Hypertension. Gastroenterol Hepatol (N Y) . 2021 Jan;17(1):40-42.

Gao et al. Pharmacological management of portal hypertension: current status and future. Chin Med J (Engl). 2020 Oct 5; 133(19): 2362–2364.

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