Pharmacological therapy of portal hypertension Rafał Paluszkiewicz Medical Science Review - Hepatologia 2009; 9 85-90 aaICID: 902249
Article type: Review article
IC™ Value: 3.04
Abstract provided by Publisher
In the last 20 years, major advances in the management of portal hypertension have resulted in a significant decrease in bleeding-related mortality. Pharmacological treatment of portal hypertension includes vasoconstrictors to decrease portal blood inflow, vasodilators to decrease hepatic resistance, and combination therapy. Oral agents, such as nonselective beta-blockers and organic nitrates, are used for long-term primary and secondary prophylaxis of variceal bleeding, while parenteral agents, such as terlipressin and somatostatin (and analogues), are used for the treatment of acute variceal bleeding. Terlipressin and somatostatin are now used usually in combination with endoscopic variceal ligation (EVL). Nonselective beta-blockers, either alone or in combination with EVL, are the recommended therapy for the prevention of first variceal bleeding and rebleeding. New drugs may target selective sites, such as carvedilol, which may reduce intrahepatic resistance without affecting the systemic circulation.