Pharmacotherapy of upper gastrointestinal bleeding along with its utility at tertiary care hospital

Abstract

Acute upper gastrointestinal bleeding (AUGIB) is the most common GI emergency observed with mortality of 6-10% overall. The authors aimed to assess the pharmacotherapy of upper gastrointestinal bleeding along with its drug utility and their performance. A total of 120 patients were enrolled meeting the criteria and observed that the main cause of upper gastrointestinal bleeding was found to be esophageal varices followed by duodenal ulcers. The major contributing factor for UGI bleed was alcohol and smoking. The study revealed that males are predominantly being affected with UGI bleed; probable reasons may be habitual behaviour of the patients. Majority of the population who are affected were associated with comorbidities like hypertension, cirrhosis, jaundice, hepatitis, ulcers and diabetes mellitus. Portal hypertension was the major complication seen among the study population, followed by Jaundice and Ascites.The most common cause of portal hypertension is cirrhosis of liver. As an initial evaluation modality of all our UGI bleed patients were done with UGI endoscopy for both therapeutic and diagnostic purposes. The most commonly prescribed drugs were anti-secretory agents [pantoprazole], mucosal protectants [sucralfate], vasoactive agents [terlipressin], antibiotics [rifampicin, ceftriaxone, metronidazole]. It is observed in the study with high dose of alcohol consumption results into serious complications and increasing mortality and morbidity.  In the modern era of medical management, it would be better to deal with rational drug prescription in association with clinical pharmacologist suggestions during medical rounds by clinician.