Pharmacological treatment of portal hypertension: Hemodynamic effects and prevention of bleeding

Lebrec, Didier

doi:10.1016/0163-7258(94)90059-0

Cited by 51 publications

(58 citation statements)

References 222 publications

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“…There are mainly two types of pharmacological approach to reduce portal hypertension: by decreasing portal blood flow or by decreasing portal vascular resistance (PVR). The former is the basis for use of vasoconstrictors, the latter, vasodilators [2,3,18]. Prazosin belongs to the category of vasodilators and a decrease of PVR by prazosin has been documented in portal hypertensive patients and rats [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Current drugs for the treatment of portal hypertension are quite limited due to their side effects or low efficacy. Vasopressin and somatostatin are two widely used drugs in the treatment of acute variceal bleeding, while propranolol is used as a prophylactic drug for the primary and secondary prevention of variceal bleeding [2,3]. Nevertheless, severe systemic or coronary vasoconstriction is the major drawback of vasopressin [2,4], while about one third of cirrhotic patients do not respond to propranolol [3].…”

Section: Introductionmentioning

confidence: 99%

“…It has been reported that the portal pressure gradient is an important risk factor for esophageal variceal hemorrhage, a major complication of portal hypertension [1,2]. The pharmacological treatment of portal hypertension aims at treating acute bleeding episodes or at preventing variceal bleeding [2,3]. Current drugs for the treatment of portal hypertension are quite limited due to their side effects or low efficacy.…”

Section: Introductionmentioning

confidence: 99%

“…Vasopressin and somatostatin are two widely used drugs in the treatment of acute variceal bleeding, while propranolol is used as a prophylactic drug for the primary and secondary prevention of variceal bleeding [2,3]. Nevertheless, severe systemic or coronary vasoconstriction is the major drawback of vasopressin [2,4], while about one third of cirrhotic patients do not respond to propranolol [3]. In this context, efforts were made in trying to find some potential portal hypotensive drugs [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Portal Hypotensive Effects of DL-028 and Prazosin on Portal Hypertensive Rats

Huang¹,

Lin²,

Chern

et al. 1998

Pharmacology

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The portal hypotensive effects of prazosin and DL-028 (chem- ical name: 3-[[4-(2-methoxyphenyl)piperazin-1-yl]methyl]- 2,3-dihydroimidazo[1,2-c]quinazolin-5(6H)-one(27b)), a synthetic α₁-adrenoceptor antagonist, were assessed in portal hypertensive rats. Portal hypertension was induced by partial portal vein ligation in Sprague-Dawley rats. Two weeks after ligation, when the hyperdynamic state was stabilized the rats were anesthetized after an overnight fast and cannulated for measuring mean arterial pressure (MAP), portal venous pressure (PVP), cardiac index (CI) and heart rate (HR). Both DL-028 and prazosin (1, 3.3 and 10 µg/kg) induced dose-dependent decreases of PVP and MAP after intravenous infusion, with effects lasting for longer than 30 min. The maximum percentage reduction of PVP after DL-028 was 10, 10 and 15%, respectively, for the dosages given (1, 3.3 and 10 µg/kg), and 5, 12 and 25%, respectively, after prazosin. CI was not changed by either drug. HR was not changed by either drug except DL-028 at 10.0 µg/kg with a bradycardiac effect. Our results showed that both DL-028 and prazosin reduced PVP in portal hypertensive rats.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Portal Hypotensive Effects of DL-028 and Prazosin on Portal Hypertensive Rats

Huang¹,

Lin²,

Chern

et al. 1998

Pharmacology

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“…Certain factors were shown to be associated with the risk of rebleeding in of portal hypertension, only -adrenoceptor antagonists are used to prevent recurrent hemorrhage in patients with patients with cirrhosis receiving propranolol [4]: occurrence of hepatocellular carcinoma, lack of compliance, cirrhosis [1]. Controlled trials comparing endoscopic sclerotherapy with or without -adrenoceptor antago-lack of persistent decrease in heart rate, lack of alcohol abstinence and previous history of bleeding.…”

mentioning

confidence: 99%