Antiplatelet Agents - Mechanism Of Action, List Of Drugs

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Antiplatelet agents: a list of drugs

Antiplatelet agents are a group of medicines that are designed to suppress the process of thrombus formation by inhibiting the adhesion of platelets to each other. In addition, taking antiplatelet agents prevents platelets from adhering to the vascular wall. As a result, the rheological properties of blood increase, and the blood coagulation system will be inhibited. Antiplatelet agents help break down existing blood clots.

Erythrocyte membranes become less elastic, they easily change their shape and can penetrate through the wall of blood vessels. Blood flow improves, the risk of complications of thrombosis decreases. Taking antiplatelet agents in the early stages of thrombus formation allows you to achieve the maximum effect.

Antiplatelet agents are widely used in medicine. They are prescribed as prevention of thrombosis after surgery, with ischemic heart disease, with acute cerebral ischemia, with thrombophlebitis and postinfarction cardiosclerosis.

Any cardiac disease is associated with the risk of formation of cholesterol plaques in the vessels. They narrow the lumen of the vessel, do not allow blood to flow normally through it. The slowing down of blood flow in a certain area, as well as its thickening, leads to the fact that a blood clot begins to form in this place. If its separation occurs, then the particles of the thrombus with the blood flow, are carried through the vessels, clog the lumen of small arteries and cause acute ischemic damage to the myocardium and brain, which is accompanied by severe complications, up to death.

Prevention of stroke and heart attack is based on the administration of anticoagulant and antiplatelet drugs. However, neither one nor the other is able to destroy the formed blood clot. They simply do not allow it to grow further, thereby preventing the blockage of blood vessels. Antiplatelet agents are prescribed to people who have undergone acute ischemia, which allows such patients to survive.

Anticoagulant drugs are more aggressive than antiplatelet agents. In addition to being more expensive, taking them is associated with much higher risks of complications.

Content:

• When are antiplatelet agents prescribed?
• Contraindications to the use of antiplatelet agents
• Side effects
• List of drugs
• Combined medicines with antiplatelet effect

When are antiplatelet agents prescribed?

Antiplatelet agents are prescribed for the following indications:

• Ischemic disorders in the body.
• Presence of a predisposition to the formation of blood clots.
• Atherosclerotic vascular lesions.
• Angina pectoris.
• Coronary heart disease.
• Stable increase in blood pressure.
• Obliterating endarteritis.
• Placental insufficiency.
• Arterial thrombosis.
• Dyscirculatory encephalopathy, cerebral ischemia.
• Postponed heart bypass surgery, postponed blood transfusion.

Contraindications to the use of antiplatelet agents

Antiplatelet agents are not prescribed for women who are in a position, that is, they are carrying a child. Also, they should not be taken by people suffering from gastric ulcer and under the age of 18.

Other contraindications to the use of antiplatelet agents include:

• Erosive and ulcerative lesions of the digestive tract.
• Disorders of the kidneys and liver.
• The presence of blood in the urine.
• Certain heart diseases.
• Aspirin triad.
• Bronchial spasm.
• Bleeding.
• Thrombocytopenia.
• Lack of vitamin C and vitamin K.
• Heart aneurysm.
• Anemia.

Side effects

Antiplatelet agents can cause the following side effects:

• Allergic reactions.
• Intoxication of the body.
• Bleeding and hemorrhage, vasculitis, decreased blood pressure.
• Disorders in the work of the digestive system.
• Pain in the heart, muscles, joints.
• Arrhythmia, shortness of breath.
• Dysuric disorders, the appearance of blood in the urine, hepatosplenomegaly.
• Sleep problems, tremors and paresis of the limbs, emotional disorders.

List of drugs

The list of antiplatelet agents is quite extensive. Most drugs from this group are prescribed not only for the purpose of treatment, but also for the prevention of various complications that may occur in people suffering from cardiovascular diseases, or after surgery.

• Aspirin or Acetylsalicylic acid. Aspirin is a drug belonging to the NSAID group. This agent has a pronounced antiplatelet effect. After taking it, prostaglandin regulation of platelet hemostasis occurs. Therefore, Aspirin is prescribed to prevent the formation of blood clots. This drug is very widespread. It helps to reduce body temperature, relieves pain.

  Aspirin is taken after meals, as the drug can irritate the stomach wall and exacerbate peptic ulcer disease. To achieve a stable antiplatelet effect, you need to take the drug for a long time in small quantities. In order to prevent platelets from sticking into a thrombus and to improve the rheological properties of blood, a dosage of 1/2 tablet once a day is required.

• Ticlopidine. This drug has a pronounced antithrombotic effect, which is many times superior to that of Aspirin. Therefore, it is prescribed to patients with diagnosed ischemic lesions, when it is required to reduce blood flow to the brain. It is also recommended for people suffering from coronary heart disease, ischemia of the lower extremities, from retinopathy against the background of diabetes mellitus. If the patient has already undergone vascular bypass grafting, then Ticlopidine is prescribed to him for a long time.

  Ticlopidine prolongs any bleeding, inhibits the process of blood clotting, inhibits platelet aggregation. You should not take Ticlopidine in conjunction with other antiplatelet and anticoagulants. The full course of treatment is equivalent to 3 months. At this time, a person should be regularly monitored by a doctor and donate blood for analysis.

  After taking Ticlopidine, it is rapidly absorbed into the bloodstream, which is its main feature. The therapeutic effect lasts for several days after the drug intake has been completed.

  Ticlopidine as the main active ingredient is present in the following medicines: Tiklo, Tiklid, Ticlopidin-Ratiopharm.

• Pentoxifylline. This drug not only has the effect of antiplatelet agents, but also relieves spasms, dilates blood vessels and improves blood supply to internal organs. Thanks to its reception, the rheological parameters of the blood are improved, and the heart rate remains normal.

  Pentoxifylline is classified as an angioprotective drug that enhances the elasticity of blood cells and enhances fibrinolysis. It is prescribed for intermittent claudication, for angiopathy, for post-thrombotic syndrome, frostbite, varicose veins, ischemic heart disease.

• Clopidogrel. The effect of taking Clopidogrel is similar to the effect of taking Ticlopidine. The drug prevents platelets from sticking together, eliminates their increased activity. Clopidogrel rarely gives side effects, as it has low toxicity. Therefore, if it is necessary to carry out long-term antiplatelet therapy, most specialists prescribe this particular drug to their patients.

• Dipyridamole. This is an antiplatelet drug that helps to expand the lumen of blood vessels that carry blood to the heart muscle. Its reception enhances collateral blood flow, normalizes myocardial contractility, improves venous outflow.

  Dipyridamole has a vasodilating effect, but if you combine it with other drugs, you can achieve an antiplatelet effect. It is recommended for admission to patients who have a high risk of blood clots, as well as patients who are recovering after surgery for the installation of a heart prosthesis.

• Curantil. Curantil is a drug based on the active ingredient dipyridamole. Curantil is prescribed to a wide range of people, since it is not contraindicated in pregnant and lactating women. Thanks to its intake, the blood vessels expand, the risk of blood clots is reduced, and the heart receives a sufficient amount of nutrients.

  The drug is recommended for women in a position if they have suffered placental insufficiency, or they have heart and vascular diseases. Its purpose allows you to prevent oxygen starvation of the fetus, which will receive a maximum of nutrients.

  Another effect of Curantil is to increase immunity. During its intake, interferon is actively produced, which reduces the risks of developing a viral infection in a pregnant woman.

• Eptifibatid. This drug is prescribed for patients who have undergone percutaneous coronary artery bypass grafting, as well as those who have heart disease. The drug is prescribed in a complex treatment regimen with Aspirin, Heparin and Clopidogrel. Before therapy, the patient is subject to a thorough examination, which is especially important for people over 60 years old and for women.

  The drug is administered intravenously in a hospital setting. After returning home, the patient will have to take his pill form for several months. Possible lifelong intake of antiplatelet agents, which prevents the risks of thromboembolytic complications.

  If the patient needs emergency surgery, then the drug is canceled. When the operation is planned, you should refuse to accept it a few days before it.

• Iloprost. This medication is to be used only in a hospital room. Before its appointment, the patient should be carefully examined. The solution to be injected is prepared in advance. If a person receives Iloprost, they should quit smoking. Under the condition of undergoing treatment for hypotension, it is necessary to measure the level of blood pressure before administering the drug. This will prevent it from falling sharply.

  In Ventavis, Iloprost acts as an artificial replacement for prostaglandin, it is used in the form of a solution for inhalation. Iloprost is prescribed for pulmonary hypertension, regardless of its nature. This allows you to expand the vessels that feed the lung tissue and increase the rheological properties of the blood.

Combined medicines with antiplatelet effect

Modern pharmacology offers patients in need of antiplatelet treatment, drugs with a combined effect. Such medicines contain several antiplatelet agents at once, which mutually reinforce each other's action.

Among these drugs:

• Agrenox, which contains Aspirin and Dipyridamole.
• Aspigrel with Aspirin and Clopidogrel in the composition.
• Coplavix. Its composition is similar to that of Aspigrel.
• Cardiomagnet, which contains Aspirin and magnesium.

Antiplatelet agents are drugs that are widely used in the treatment of various pathologies. They are prescribed to their patients by cardiologists, neurologists, vascular surgeons.

Professor A. G. Obrezan Antiplatelet agents for cardiovascular pathology:

Galyavich A. S. - antiplatelet therapy for ACS: problems and solutions:

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.