Wednesday, December 12, 2018

Chylothorax - Adjuvant Rx

Q: Which of the following drugs is said to be helpful in the management of chylothorax?

A) Corticosteroids
B) Hydralazine
C) Lopressor
D) Midodrine
E) Lisinopril


Answer: D

Midodrine is an alpha 1-adrenergic agonist and causes vasoconstriction of the lymph system. It is shown to be effective in patients who do not respond to dietary modifications and surgical intervention.


Other drug which has efficacy in chylothorax is octreotide, a somatostatin analogue. 


Other choices have no role in chylothorax.


#pharmacology

#surgicalcriticalcare


References:

1. Liou DZ, Warren H, Maher DP, et al. Midodrine: a novel therapeutic for refractory chylothorax. Chest 2013; 144:1055. 

2. Use of an alpha-1 adrenoreceptor agonist in the management of recurrent refractory idiopathic chylothorax. Chest 2018; 154:e1. 

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