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antiplatelet_drug

Antiplatelet drug

Drugs that interfere with platelet function can be classified into 3 categories:

Those that prevent cardiovascular disease (primary prevention), those that treat an acute disease, and those that treat a chronic disease (secondary prevention)

There are both oral (taken by mouth) and intravenous (given through a vein) drugs that inhibit platelet function and are used to treat patients with cardiac and cerebrovascular diseases.

see Dual antiplatelet therapy.

Classification

The class of antiplatelet drugs include:

Irreversible cyclooxygenase inhibitors

Aspirin

Triflusal (Disgren)

Adenosine diphosphate (ADP) receptor inhibitors

Clopidogrel (Plavix)

Prasugrel (Effient)

Ticagrelor (Brilinta)

Ticlopidine (Ticlid)

Phosphodiesterase inhibitors

Cilostazol (Pletal)

Protease-activated receptor-1 (PAR-1) antagonists

Vorapaxar (Zontivity)

Glycoprotein IIB/IIIA inhibitors (intravenous use only)

Abciximab (ReoPro)

Eptifibatide (Integrilin)

Tirofiban (Aggrastat)

Adenosine reuptake inhibitors

Dipyridamole (Persantine)

Thromboxane inhibitors

Thromboxane synthase inhibitors

Thromboxane receptor antagonists

Terutroban


A platelet count of less than 135,000/µL in patients on antiplatelet therapy is predictive of both radiographic and clinical worsening. This is a clinically relevant target intended to help tailor and improve management in patients on antiplatelet therapy.


An anonymous survey of 11 multiple-choice questions about management of aSAH patients with antiplatelet use before the initial hemorrhage was distributed to the international panel of attendees of the European Association of Neurosurgical Societies (EANS) annual meeting in Venice, Italy at 1-5 October 2017.

A total of 258 (54%) completed surveys were returned. In about 80%, the departments of neurosurgery and neurology were responsible for acute management of aSAH patients, whereas in 15% the intensive care unit. Department guidelines were present in 32%. In 65%, the responders always stop the antiplatelet agent at admission and in 4.3% are thrombocytes always transfused. When a guideline is present, the neurospecialists consider thrombocyte transfusion more often (83% vs. 65% p=0.02).

The survey among mainly European neurosurgeons show that there is a significant variability in the management of aSAH patients who have been using antiplatelets before the initial hemorrhage. These findings emphasize the importance of the development of evidence-based guidelines for management of patients with aSAH and antiplatelet use before the initial hemorrhage 1).

1)
Sebök M, Keller E, van Niftrik CHB, Regli L, Germans MR. Management of aneurysmal subarachnoid hemorrhage patients with antiplatelet use before the initial hemorrhage: an international survey. World Neurosurg. 2018 Aug 24. pii: S1878-8750(18)31877-1. doi: 10.1016/j.wneu.2018.08.094. [Epub ahead of print] PubMed PMID: 30149168.
antiplatelet_drug.txt · Last modified: 2018/09/06 13:19 by administrador