UGIB dose octeotide

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UGIB

Drug Therapy (TinTin 7th ed)

Proton pump inhibitors reduce rebleeding and the need for surgery in the treatment of bleeding peptic ulcers.9,10 They are best used as an adjunct to endoscopic therapy. IV regimens are a 60-milligram bolus followed by a continuous infusion of 6 milligrams/h for lansoprazole, and an 80-milligram bolus followed by a continuous infusion of 8 milligrams/h for esomeprazole and pantoprazole.11,12

Infusions of somatostatin or its derivative, octreotide, have been used in treating patients with UGI hemorrhage. Octreotide is inferior to endoscopic techniques but may be considered for patients with uncontrolled bleeding awaiting endoscopy or when endoscopy is unsuccessful, contraindicated, or unavailable.5 The dose is 25- to 50-microgram IV bolus followed by IV infusion of 25 to 50 micrograms/h. Use the lower dosage for the elderly or those with severe liver disease.

Vasopressin has also been used to control GI bleeding, most commonly from varices. However, adverse reactions are more common, including hypertension, dysrhythmias, myocardial and splanchnic ischemia, decreased cardiac output, and gangrene from local infiltration. It has been largely supplanted by other options.

 

Drug Therapy (Schwartz's Principles of Surgery )

Somatostatin and its analogue octreotide (initial bolus of 50 g IV followed by continuous infusion of 50 g/h) also cause splanchnic vasoconstriction. Octreotide has the advantage that it can be administered for 5 days or longer

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