Active substances: Norfloxacin
For these reasons, before you start taking norfloxacin it is important that your doctor knows: If you are pregnant, trying for a baby,. If you are under 18 years of age.
Drug selection is dependent on local resources. Terlipressin should be the first choice because it is the only drug that has demonstrated survival improvement.
Treatment can begin, even during patient transfer, which can increase survival in patients with massive bleeding; furthermore, these drugs can facilitate the endoscopic procedure. A long-acting drug derived from vasopressin, terlipressin is a triglycil lysine.
It has a lower number of side effects, mainly abdominal pain.
When variceal bleeding is suspected, a dose of 2 mg every 4 h for the first 48 h is recommended, followed by a reduced dose of 1 mg every 4 h for up to 5 days.
An analog of somatostatin, this drug has a longer half-life, although it does not have a longer hemodynamic effect. Its safety profile is similar to that of somatostatin and its effect is comparable to terlipressin.
However, none of the studies has been double-blinded and so they lack strength. Endoscopic therapy ES consists of the intravariceal or paravariceal injection of a sclerosing agent.
It is carried out every 10 to 14 days until the varices are eradicated, which takes an approximate 5 to 6 sessions. In EL, the varices are strangled through the application of elastic bands on the varicose vein, usually placing 5 to 8 bands per session.
EL of the EV is done every 2 to 3 weeks until the varices are obliterated or until they can no longer be ligated, generally in 3 to 4 sessions. Endoscopic therapy is widely recommended in all patients presenting with acute variceal bleeding.
ES has been shown to be effective in the control of acute bleeding and in preventing rebleed, compared with medical treatment with vasopressin or balloon tamponade.
With a limited number of ELs, a positive effect was achieved in regard to the prevention of episodes of rebleeding 4 ELs in the place of ES prevent one rebleed episode and death 10 ELs instead of ES to prevent one death.
EL has fewer complications, does not increase portal pressure compared with sclerotherapy,129 and requires fewer procedures to eradicate EV.