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Antiplatelet agents are a group of drugs that are designed to suppress the process of thrombosis by inhibiting the adhesion of platelets to each other. In addition, taking antiplatelet agents prevents platelets from sticking to the vascular wall. As a result, the rheological properties of blood increase, and the blood coagulation system will be inhibited. Antiplatelet agents allow the destruction of already existing blood clots.
The membranes of erythrocytes become less elastic, they easily change their shape and can penetrate the wall of blood vessels. Blood flow improves, the risk of developing 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 a prevention of thrombus formation after surgical interventions, with coronary 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 it detaches, then the particles of the blood clot 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 taking 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 blockage of blood vessels. Antiplatelet agents are prescribed to people who have suffered acute ischemia, which allows saving the lives of such patients.
Anticoagulant preparations are more aggressive than antiplatelet agents. In addition to being more expensive, they are associated with a much higher risk of complications.
When are antiplatelet agents prescribed?
Antiplatelet agents are prescribed for the following indications:
Ischemic disorders in the body.
The presence of a predisposition to the formation of blood clots.
Atherosclerotic vascular disease.
Angina pectoris.
Cardiac ischemia.
Stable increase in blood pressure.
Obliterating endarteritis.
placental insufficiency.
Arterial thrombosis.
Dyscirculatory encephalopathy, cerebral ischemia.
Past heart bypass surgery, past blood transfusion.
Contraindications to the use of antiplatelet agents
Antiplatelet agents are not prescribed to women who are in position, that is, they are carrying a child. Also, they should not be taken by people suffering from stomach ulcers and under the age of 18 years.
Other contraindications to the use of antiplatelet agents include:
Erosive and ulcerative lesions of the digestive tract.
Disorders in the work of the kidneys and liver.
The presence of blood in the urine.
Some heart diseases.
aspirin triad.
Spasm of the bronchi.
Bleeding.
Thrombocytopenia.
Lack of vitamin C and vitamin K in the body.
Aneurysm of the heart.
Anemia.
Side effects
Antiplatelet agents can cause the following side effects:
Allergic reactions.
body intoxication.
Bleeding and hemorrhage, vasculitis, lowering blood pressure.
Violations of the digestive system.
Pain in the heart, in the muscles, in the joints.
Arrhythmia, shortness of breath.
Dysuric disorders, the appearance of blood in the urine, hepatosplenomegaly.
Sleep problems, tremor and paresis of the limbs, emotional disorders.
Drug List
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 group of NSAIDs. This remedy has a pronounced antiplatelet effect. After its administration, 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 cause an exacerbation of peptic ulcer. 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 together into a thrombus and improve the rheological properties of the blood, a dosage of 1/2 tablet 1 time per day will be required.
Ticlopidine . This drug has a pronounced antithrombotic effect, which is many times greater than the effect of Aspirin. Therefore, it is prescribed to patients with diagnosed ischemic lesions when it is necessary to reduce blood flow to the brain. It is also recommended to be taken by people suffering from coronary heart disease, from ischemia of the lower extremities, from retinopathy against the background of diabetes mellitus. If the patient has already undergone vascular bypass surgery, then Ticlopidin is prescribed to him for a long time.
Ticlopidin prolongs any bleeding, inhibits the process of blood clotting, inhibits platelet aggregation. Do not take Ticlopidin in conjunction with other antiplatelet agents and anticoagulants. The full course of treatment is equivalent to 3 months. At this time, a person should be regularly observed by a doctor and donate blood for analysis.
After taking Ticlopidin, it is rapidly absorbed into the blood, which is its main feature. The therapeutic effect persists for several days after the drug has been completed.
Ticlopidin as the main active ingredient is present in the following medicines: Tiklo, Ticlid, 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 intake, the rheological parameters of the blood improve, while the heart rate remains normal.
Pentoxifylline is referred to as angioprotective drugs that increase the elasticity of blood cells and enhance fibrinolysis. It is prescribed for intermittent claudication, angiopathy, post-thrombotic syndrome, frostbite, varicose veins, coronary heart disease.
Clopidogrel . The effect of taking Clopidogrel is similar to the effect of taking Ticlopidin. The drug prevents the adhesion of platelets, eliminates their increased activity. Side effects Clopidogrel rarely gives, as it has low toxicity. Therefore, if it is necessary to conduct long-term antiplatelet therapy, most specialists prescribe this drug to their patients.
Dipyridamole . This is an antiplatelet drug that helps to expand the lumen of the blood vessels that carry blood to the heart muscle. Its reception enhances collateral blood flow, normalizes myocardial contractility, improves venous outflow.
Dipyridamole has a vasodilatory effect, but if you combine it with other drugs, you can achieve an antiplatelet effect. It is recommended for patients who have a high risk of blood clots, as well as for patients recovering from heart prosthesis surgery.
Curantyl . Curantil is a drug based on the active ingredient dipyridamole. Curantyl is prescribed to a wide range of people, since it is not contraindicated in pregnant and lactating women. Thanks to its intake, blood vessels dilate, the risk of blood clots is reduced, and the heart receives a sufficient amount of nutrients.
The drug is recommended for use by women in a position if they have suffered fetoplacental insufficiency, or they have diseases of the heart and blood vessels. Its purpose allows you to prevent oxygen starvation of the fetus, which will receive maximum nutrients.
Another effect of Curantyl is an increase in immunity. During its reception, there is an active production of interferon, which reduces the risk of developing a viral infection in a pregnant woman.
Eptifibatide. This drug is prescribed to patients who have undergone percutaneous coronary artery bypass grafting, as well as to those patients 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 of age and for women.
The drug is administered intravenously in a hospital. After returning home, the patient will have to take it in tablet form for several months. Lifelong use of antiplatelet agents is possible, which helps to prevent the risks of developing thromboembolic complications.
If the patient requires emergency surgery, the drug is canceled. When an operation is planned, it should be refused from taking it a few days before it is carried out.
Iloprost . This drug should only be used in a hospital ward. Before his appointment, the patient must be carefully examined. The solution, which will be administered in the form of injections, is prepared in advance. If a person is receiving Iloprost, they should stop smoking. Subject to 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 the Ventavis preparation, 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 drugs with antiplatelet effect
Modern pharmacology offers patients in need of antiplatelet treatment, drugs with a combined effect. These drugs 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 Aspigrell.
Cardiomagnyl 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.
Galyavych A.S. — antiplatelet therapy in ACS: problems and solutions: