The nurse would anticipate using which medication if sclerotherapy has not been used?
A. Neomycin
B. Propranolol
C. Vasopressin
D. Cimetidine
Correct Answer: C. Vasopressin
Vasopressin is the drug of choice when sclerotherapy is contraindicated. Vasoactive drugs stop bleeding in most patients, and emergency sclerotherapy may carry risks to the patient and is more demanding on the healthcare system. Sclerotherapy did not appear to be superior to vasoactive drugs in terms of control of bleeding, the number of transfusions, 42?day rebleeding and mortality, or rebleeding and mortality before other elective treatments.
Option A: Neomycin is used in preventing encephalopathy when blood is broken down. Neomycin belongs to a group of antibiotics known as aminoglycosides. Like others in the aminoglycoside family, neomycin works by inhibiting bacterial protein synthesis leading to its bactericidal effect. This group of medications is particularly effective in killing gram-negative organisms allowing for good coverage of enteric organisms.
Option B: Propranolol may or may not be used to decrease cardiac output and hepatic venous pressure. Propranolol can be used to ameliorate the sympathetic response in angina, tachyarrhythmias, prevention of acute ischemic attacks, migraine prophylaxis, and restless leg syndrome. Propranolol can be used in almost all cases if the desired result is to slow contractility and decrease a patient’s heart rate.
Option D: Cimetidine is a drug with the indication of peptic ulcer disease, gastroesophageal reflux disease, and for dermatological conditions including warts, urticaria, mastocytosis, and erythropoietic protoporphyria. This medication is an H2 receptor antagonist.
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