In severe esophageal variceal bleeding, which medications are used to constrict dilated vessels?

In the management of severe esophageal variceal bleeding, the use of vasopressin and octreotide is crucial because these medications effectively constrict dilated blood vessels, thus reducing blood flow to the varices and helping to minimize bleeding. Vasopressin works by increasing systemic vascular resistance through direct vasoconstriction, specifically targeting the splanchnic circulation, which is where varices are located. This helps decrease portal venous pressure, which can alleviate the bleeding from the varices.

Octreotide, a synthetic analogue of somatostatin, also serves to reduce portal pressure by inhibiting the release of various hormones that modulate blood flow in the gastrointestinal tract, further contributing to the control of variceal hemorrhage.

Other options do not directly address the issue of constricting dilated vessels in the context of variceal bleeding. Antibiotics play a role in preventing infections post-bleeding, while antihypertensives generally relate to managing blood pressure rather than treating the bleeding. Proton pump inhibitors and H2 blockers are utilized for managing acid-related conditions rather than controlling variceal bleeding directly. Finally, analgesics and antiemetics, while important for symptom management in various contexts, do not influence