Antiaggregants: a list of drugs. Anticoagulants and antiplatelet agents, their characteristics
Increased coagulation often causes thrombosis, leading to severe consequences, including death. Achievements of pharmacology allow saving lives for patients with such pathology due to maintenance therapy in the form of antiplatelet drugs.
What is anticoagulants?
The rheological properties of blood are provided by an equilibrium between coagulation and anticoagulant systems. In the maintenance of this balance, I take antithrombin III and heparin as natural anticoagulants, which perform a direct antithrombotic function, that is, prevent the formation of a thrombus. The mechanism of action of the latter is associated with the formation of a complex with antithrombin III, resulting in the formation of active antithrombin. He, in turn, is responsible for binding thrombin, making it inactive - this also contributes to the inhibition of thrombosis. Antithrombin III itself also possesses anticoagulant properties, inactivating thrombin, however this reaction proceeds very slowly.
The ability of heparin to ensure the inactivation of thrombin directly depends on the amount of antithrombin III in the blood. Required dose adjustment based on the analysis. Often, the appointment of two drugs at once - heparin and antithrombin III, with dosages selected individually for each person.
Binding to antithrombin is not the only function of heparin. In addition, it is able to cleave fibrin without the involvement of plasmin, which is called non-enzymatic lysis. This reaction is associated with the formation of compounds with various biologically active substances, among which peptides and hormones. Among other functions, the suppression of a number of enzymes, involvement in the inflammatory process( reduces its intensity), as well as activation of lipoprotein lipase and improvement of blood flow in the vessels of the heart.
What is antiaggregants?
Anticoagulants and antiaggregants are used effectively in medicine. This name has been obtained by means that suppress the gluing( aggregation) of blood cells - platelets and red blood cells. The mechanism of action of these substances is different, which made it possible to identify several groups. Antiaggregants, whose list of preparations is extensive, are classified as follows.
- Calcium antagonists( "verapamil").
- Inhibitors of enzymes, which include substances that inhibit cyclooxygenase( acetylsalicylic acid, Naproxen, Indomethacin), as well as adenylate cyclase and phosphodiesterase( Ticlopidine, Pentoxifylline).
- Drugs that stimulate the formation of prostacyclin( "Pyrazolin").
- Prostanoids( "Prostacyclin" and its analogues of a synthetic nature).
- Drugs that suppress the release of substances contained in platelets( "Piracetam").
Antiaggregants are drugs whose names are known to many by wide application. The main function of this group is the prevention of thrombosis. Antiaggregants are drugs that are effectively used in a number of cardiovascular pathologies, as well as after surgery( prosthetic heart valves).
List of antiplatelet agents
Aspirin, Sulfinpirazone, Indomethacin
Atherosclerosis, artificial valves, coronary heart disease
Dipyridamole, Ticlopidine, Suloktidil, Pyracetam, Tsetediel
Unstable angina, atherosclerosis
Antiaggregants: a list of drugs that are often used in medical practice
There are a lot of drugs that belong to this group, and all of them have their own characteristics. The choice of a medication depends on the clinical case. And, naturally, self-medication in this situation is inappropriate.
Eicosanoids are involved in the regulation of hemostasis, which are a product of oxidation of arachidonic acid. Among them, thromboxane A2 is most important, and its main function is the provision of platelet aggregation. The action of aspirin is directed to the inhibition of the enzyme, which was called cyclooxygenase. As a result, the synthesis of thymboxane A2 is suppressed, therefore, thrombogenesis processes are suppressed. The effect increases with the repeated administration of the drug due to cumulation. To fully suppress cyclooxygenase, a daily intake is required. The optimal dosage reduces the likelihood of "Aspirin" side effects, even with constant use. Dose increase is unacceptable, since there is a risk of complications in the form of bleeding.
The effect of the drug is based on the blocking of certain receptors responsible for thrombus formation. Normally, when ADP binds to them, the platelet form changes and aggregation is stimulated, and "Ticlopidine" inhibits this process. The feature of this antiaggregant is its high bioavailability, which is achieved by a high rate of absorption. After withdrawal, the effect is observed for another 3-5 days. The disadvantage is a large number of side effects, among which nausea, diarrhea, thrombocytopenia and agranulocytosis are common.
The antiaggregant is similar in type to Ticlopidine, but its advantage is relatively low toxicity. In addition, the risk of side effects when taking this drug is much lower. Currently, specialists prefer "Clopidogrel" due to the absence of complications in the form of agranulocytosis and thrombocytopenia.
The drug disrupts aggregation by blocking the glycoprotein, which is located in the platelet membrane. It is prescribed for intravenous fluid administration, usually with angina and angioplasty to reduce the likelihood of myocardial infarction.
The main effect of the drug is vasodilation, that is, vasodilatation, but when combined with other drugs, a pronounced antiaggregant effect is observed."Dipiridamole" is prescribed together with "Aspirin" if there is a high risk of thrombus formation. It is also possible to combine with Warfarin, which is effectively used after prosthetic heart valves to reduce the likelihood of embolism. With monotherapy, the effect is less pronounced.
Antiaggregants are drugs( list: "Eliksvis", "Klopidogrel" and others), widely used in practice.
Assignment of antiplatelet agents requires careful collection of an anamnesis that includes information on associated pathologies. If you have this or that disease, which is a contraindication for taking medications of this group, correction of the treatment plan is necessary. In such cases, individual selection of funds and their dosages is carried out, and therapy is carried out under the strict supervision of a physician. In no case should the self-prescribed antiplatelet agents be allowed, since the consequences can be disastrous.
List of contraindications:
- hemorrhagic diathesis;
- risk of bleeding;
- severe liver and kidney failure;
- arrhythmias in the anamnesis;
- severe arterial hypertension;
- obstructive diseases of the respiratory system;
- children's age( for most drugs).
In addition, many antiaggregants( a list of drugs reviewed in this article) are contraindicated in pregnancy and lactation. During this period, preference should be given to medicines that will be safe for both the child and the mother.
Antiaggregants. Drugs: Pregnancy List
In case of impaired blood circulation of the fetus, there is a risk of abortion. This phenomenon was called fetoplacental insufficiency. If the delivery of oxygen to the blood is impaired, the fetus develops severe hypoxia, which threatens not only abnormalities in its development, but also death. When diagnosing such a pathology, immediate treatment is required, which is to improve blood flow, reduce blood viscosity. For this, antiplatelet agents are prescribed, but it should be remembered that not all drugs of this group are safe during pregnancy. It is acceptable to use only certain tools.
The drug is very popular due to the fact that in the list of its contraindications there are no pregnancy and breastfeeding. The active substance "Kurantila" is a previously described dipyridamole, which dilates the blood vessels, and also suppresses thrombus formation. The drug improves the blood supply to the heart muscle, ensuring the delivery of the required amount of oxygen. Due to this, K "Urantil" can be used in the presence of cardiovascular pathology in a pregnant woman. However, the main indication for prescribing it to pregnant women is fetoplacental insufficiency. Due to the improvement of the rheological properties of the blood and vasodilation, the placental vessels are blocked, therefore the fetus does not suffer from hypoxia. An additional advantage of the drug can be called immunomodulating effect. The drug stimulates the production of interferon, resulting in a reduced risk of viral diseases in the mother. Although "Kurantil" and can be used in pregnancy and lactation, however, it is only necessary to prescribe it if there is evidence. When taking the drug should reduce the consumption of tea and coffee, as they reduce its effectiveness. Antiagreganty - drugs( list above), which should not be combined with such drinks. Although during pregnancy they are not advised to get carried away in any case.
Antiaggregants, a list of drugs which number dozens of names, are effectively used in the treatment of diseases of the cardiovascular system. However, one should remember about possible complications associated with reduced blood viscosity and suppression of clotting. Antiagreganty - drugs that can be used only under the supervision of the attending physician, he will select the necessary dosage and course of therapy.