Question

What is the initial pharmacologic management for suspected acute esophageal variceal bleeding?

• A. Non-selective beta-blockers alone
• B. Proton pump inhibitors
• C. Vasoactive agents (e.g., octreotide or terlipressin)
• D. Urgent beta-blocker prophylaxis

Hint:

Combine vasoactive drugs with antibiotics and early endoscopy for optimal control of variceal hemorrhage.

Answer 1

The Correct Option is C

Step 1: Understanding the question.
Acute variceal bleeding requires immediate reduction of portal pressure pharmacologically.
Step 2: Analyzing the options.
(A) Non-selective beta-blockers alone: For prophylaxis, not acute control.
(B) Proton pump inhibitors: Not indicated for variceal bleed.
(C) Vasoactive agents (e.g., octreotide or terlipressin): Correct — Started immediately upon suspicion.
(D) Urgent beta-blocker prophylaxis: Secondary prevention after control.
Step 3: Conclusion.
The correct answer is (C) Vasoactive agents, the initial pharmacologic therapy for acute variceal bleeding.