glypressin

Gastric mucosal perfusion is increased in portal-hypertensive gastropathy, and this may contribute to gastric bleeding from these lesions. Therefore drugs reducing gastric mucosal perfusion may be beneficial in the treatment of overt bleeding from portal-hypertensive gastropathy. In this study gastric mucosal perfusion was assessed in 28 cirrhotic patients with portal-hypertensive gastropathy under basal conditions and after double-blind intravenous administration of vasopressin (0.4 U/min), glypressin (2-mg injection) or placebo, with laser-Doppler flowmetry and reflectance spectrophotometry...

This is the first randomised double-blind trial of glypressin in the treatment of acute epistaxis, where no localized bleeding point was found and where the patient would normally be treated with a form of nasal packing. It shows a statistically significant benefit with the intravenous drug compared to placebo. In addition, the dose of glypressin used to achieve control appears to be free of major side effects. Acute epistaxis is a common problem, nasal packing is unpleasant and not without side effects, and therefore an alternative form of treatment would have clear advantages...

Drug therapy for acute variceal bleeding should be viewed as an adjunct to emergency sclerotherapy. Its role in preventing very early rebleeding (within days) following sclerotherapy needs to be established. The best candidates for such a role are somatostatin and octreotide, but glypressin and vasopressin and nitroglycerin combinations have therapeutic effects in the short-term. Propranolol is the drug for long-term prevention of rebleeding and prevention of the first variceal bleed. For primary prophylaxis it significantly reduces the rate of bleeding, and there is a trend towards reducing mortality...

Eight patients with cirrhosis were infused with lysine vasopressin (10 microgram LVP) and triglyclylysine vasopressin (750 microgram and 2000 microgram Glypressin, GVP) on separate occasions. LVP infusion resulted in an increase in factor VIII, factor VIII-related antigen and plasminogen activator (PA). The factor VIII antigen: activity ratio decreased following infusion, but factor VIII electrophoretic mobility and in vitro decay rate were unchanged. GVP infusion produced no change in factor VIII or PA. Assay of vasopressin-like antigen and antidiuretic activity showed that GVP is cleaved to LVP in vivo...

Haemorrhages in the course of cirrhosis and portal hypertension are surgical emergencies. Nevertheless medical treatment may be necessary both to revive the patient and temporarily to check the haemorrhaging itself. Some views are presented on the use of drugs, both those already in clinical use and others at the experimental stage, which appear to be effective in the treatment of haemorrhaging in portal hypertension (Vasopressin, glypressin, prostaglandin, somatostatin, propranolol, cimetidine and ranitidine)...

In a randomised controlled trial the effect of intermittent bolus injection of triglycyl lysine vasopressin (terlipressin 'Glypressin') (2 mg that 6-hourly), an analogue of vasopressin, was compared with that of a constant peripheral intravenous infusion of vasopressin (0.4 units/Min) in the initial management of bleeding oesophageal varices in nineteen patients. Failure of vasopressin therapy was defined as continued bleeding of sufficient severity to necessitate the passage of a Sengstaken tube. Bleeding was controlled in 70% of patients treated with glypressin but in only 9% of patients given vasopressin...

Of four reported studies of vasopressin therapy in acute upper gastrointestinal tract hemorrhage, three found vasopressin to be effective and one did not. The studies differed with regard to population, design, and methods. The one study that found vasopressin to be ineffective in controlling gastrointestinal tract hemorrhage may have been better controlled with regard to duration of therapy and evaluation of patients. However, the population studied appeared to be different and the authors may have failed to demonstrate a beneficial effect of vasopressin in a select subgroup of patients...

No abstract text is available yet for this article.

Although not demonstrated in patients with cirrhosis, it is generally claimed that administration of vasopressin in the form of triglycyl-lysine-vasopressin (glypressin) may prevent untoward systemic effects of this former hormone. The aim of this study was to assess the effects of intravenous administration of 2 mg of glypressin on splanchnic and systemic hemodynamics in 9 patients with cirrhosis under stable circulatory conditions. One hour after the injection, the following statistically significant changes were observed as compared to the baseline values (m +/- SEM): wedged hepatic venous pressure, -9 +/- 2 p...

The effect of intravenous and topical glypressin, a triglycyl hormonogen of vasopressin, on the nasal mucosa was evaluated in healthy subjects. A dose-dependent reduction of nasal blood flow resulted from both intravenous and topical glypressin. The effect of the latter in gel form lasted 2 hours. Glypressin was also found to decongest the nasal mucosa. Topical application of glypressin gel might be an alternative to conventional treatment with intranasal packing in nose-bleed.

In a double-blind, randomized study, 50 patients undergoing conization were treated with either lysine-vasopressin (LVP) or its longer-acting analogue Glypressin. Bleeding during the operation and side effects were studied. The hemostatic effect appeared better with LVP than with Glypressin. One postoperative bleeding occurred in the whole series, in a patient treated with Glypressin. The effect on the general circulation, especially with respect to pallor of the skin, was less prominent with Glypressin than with LVP (with the concentrations used in this study)...

No abstract text is available yet for this article.

This paper reports a case of ischaemic colitis observed in a male patient with acute oesophageal variceal bleeding treated with Glypressin (triglycyl lysine vasopressin). The therapeutic effect of this substance depends on the lowering of the portal vein pressure brought about by a vasoconstriction of the vessels of the splanchnic region. The undesired complication of ischaemic colitis occurred as a result of a reduction in blood flow to the colonic mucosa.

No abstract text is available yet for this article.

The development and evaluation of a radioimmunoassay for N alpha-tri-glycyl-lysine8-vasopressin is described. The site of hapten conjugation of the immunogen has been controlled and the use of various radiolabelled tracers has been evaluated with special reference to the site of iodination. The most extensively studied antiserum showed specificity for the N-terminal triglycyl-extension as well as for several amino acid residues of the vasopressin ring. It crossreacted 27%, 28%, and 0.3% with Lys8-vasopressin, arg8-vasopressin and oxytocin respectively, and it was used to quantify triglycyl-lysine8-vasopressin in human plasma after SepPak C18 extraction...

The present-day therapy of portal hypertension and of variceal bleeding includes new drugs (propranolol, glypressin, somatostatin, a.o.) and methods of hemostasis (variceal sclerotherapy). This second part of a paper concerned with the upper digestive hemorrhage through rupture of the esophageal varices presents the main drug therapies and other various methods used to decrease the portal pressure, to achieve a direct hemostasis in case of active variceal bleeding and to prevent the rebleedings.

The variceal bleeding episode represents several days of high risk of bleeding, thus therapy should be evaluated not only in terms of immediate cessation of bleeding but also in terms of providing a bleed-free interval of a few days. As the risk of continued bleeding or very early rebleeding from varices diminishes rapidly following admission, time is an important confounding variable when comparing therapies within and between trials. Cirrhotics with better liver function are more likely to stop bleeding with simple measures than those with worse liver function...

Figure 2 is the algorithm followed in our institution for management of acute variceal hemorrhage. A small percentage of patients who present with active variceal hemorrhage will stop bleeding after gastric lavage alone. However, most patients require an intravenous vasopressin infusion at a dose of 0.4 units per minute, preferably combined with intravenous administration of nitroglycerin. Although glypressin and somatostatin may be associated with fewer side effects than vasopressin, the superiority of these drugs remains to be determined...

The systemic and hepatic haemodynamic effects following terlipressin (Glypressin) administration were studied. Bolus intravenous injections of 1.25 and 2 mg significantly decreased wedged hepatic vein pressure gradient by 29% and 31%, respectively. With each dose there was a small increase in mean arterial blood pressure but after 1.25 mg of terlipressin, estimated hepatic blood flow fell by only 11% (not significant) compared to 24% after 2 mg, while the cardiac index fell by 12% compared to 29%. The adverse haemodynamic effects of terlipressin were diminished by a decrease in dosage, without any alteration in the beneficial effect of the drug upon portal pressure...

Triglycyl-lysine-vasopressin (TGLVP) has been shown to reduce blood loss in connection with early excision of experimentally induced burns in pigs. In order to determine an appropriate dosage of TGLVP in patients with burns, a dose-response study was undertaken. TGLVP was administered intravenously in various doses to healthy volunteers, and skin blood flow was measured with laser Doppler flowmetry, thermography and plethysmography. Blood pressure, heart rate and electrocardiac activity were monitored as well as serum and urine changes...