A 55-year-old man with alcohol-related cirrhosis presents with hematemesis. Vitals show BP 94/58 mmHg, HR 118 bpm, RR 22/min, and SpO2 98% on room air. Temperature is 36.8°C. Upper endoscopy confirms actively bleeding esophageal varices. Laboratory studies reveal hemoglobin 7.2 g/dL and INR 2.1. He denies abdominal pain. He takes no current medications. Which pharmacologic agent is most appropriate for initial management?
- A)Octreotide infusion and antibioticsGABARITO
- B)Vasopressin without nitroglycerin
- C)Propranolol initiation
- D)Ceftriaxone without vasoactive drugs
- E)Fresh frozen plasma alone
Explicação
Octreotide reduces portal pressure and splanchnic blood flow, controlling bleeding. Antibiotics (ceftriaxone or norfloxacin) are given prophylactically to reduce bacterial translocation and mortality. Both should be started immediately. Ver explicação completa e trilha adaptativa →