Terlipressin

Terlipressin
	Structural formula
Mass / length primary structure	11 amino acids, 1227 Da
Identifier
External IDs	CAS number : 14636-12-5;
Drug information
ATC code	H01 BA04
DrugBank	EXPT03310
Drug class	Pituitary hormone

Terlipressin also known as terlipressin diacetate is a synthetic analogue of vasopressin . It is a peptide hormone that is active in the pituitary gland . It differs from vasopressin by 4 amino acids .

application

In the first place, terlipressin has a contracting effect on the smooth muscles of the abdominal organs and the vascular system . This means that there is a contraction of the vessels and contraction of the gastrointestinal tract and thus promotes peristalsis there , as well as the contraction of the other gynecological organs. It is used especially for complications of liver cirrhosis . It works here primarily by reducing the blood flow in the splanchnic area , which leads to a consecutive lowering of the portal vein pressure and thus reduces the risk of esophageal variceal bleeding . There are also indications that its use can also be advantageous in septic shock or after resuscitation treatment. In addition, like vasopressin, it has a slightly antidiuretic effect.

It is administered parenterally .

Contradictions

The indication must be in septic shock , hypertension , vascular diseases e.g. B. coronary arteries, advanced arteriosclerosis , advanced PAD , cardiac arrhythmias and convulsive disorders and hypovolemia must be carefully weighed. In the breast-feeding also strict indications should be respected.

Side effects

Frequently

cramping abdominal pain
nausea
Diarrhea
hypertension
Hypotension
periph. Ischemia (cave PAD , CAVK, CHD)
Arrhythmias
Bradycardia
Tachycardia
Signs of ischemia on the EKG
Pale skin
Hyponatremia
convulsive. Abdominal pain (b. Women)

Occasionally

Angina pectoris
Myocardial infarction
Lymphangitis
a headache
Trigger a seizure disorder
Chest pain
Bronchospasm
Apnea

Interactions are also particularly expected in combination with bradycardic drugs (e.g. propofol , sufentanil ). Severe bradycardias are possible in such cases .

Toxic dose : (1.7 mg / 4 hours) should not be exceeded, as the risk of serious circulatory disorders is dose-dependent.

Complications such as arterial hypertension or bradycardia can be antagonized with clonidine 150 µg or atropine . Dose: In acute esophageal variceal bleeding initially 1–2 mg, then 1 mg haemopressin every 4–6 hours - max. For 2-3 days.

Trade names

Monopreparations

Glycylpressin (D, A, CH), Haemopressin (D, A, CH)

Individual evidence

↑ Mechanisms of action of vasoconstrictive therapy of esophageal variceal bleeding. (PDF) Retrieved August 17, 2016 .
↑ T. Brünnler, et al .: Terlipressin . Intensive care and emergency medicine, Steinkopff Verlag, pp. 1435–1420, 42/5, 2005, pp. 468–478, doi : 10.1007 / s00390-005-0603-z .

Web links

[1] Mechanisms of action of vasoconstrictive therapy of esophageal variceal bleeding. (PDF) Retrieved August 17, 2016 .

[2] T. Brünnler, et al .: Terlipressin . Intensive care and emergency medicine, Steinkopff Verlag, pp. 1435–1420, 42/5, 2005, pp. 468–478, doi : 10.1007 / s00390-005-0603-z .