antiplatelet agent

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[1][2][3][4][5][6][7][8][9][10][11][12][13]

Indications

Contraindications

Dosage

Adverse effects

  • increased risk of bleeding, including upper GI bleed
drug(s) odds ratio
aspirin 81 mg 1.8
dipyridamole 1.9
clopidogrel 1.1
aspirin + clopidogrel 7.4
aspirin + dipyridamole 2.3
aspirin + warfarin 5.3
  • platelet transfusion not indicated for GI bleed
    • increased mortality, no reduction of risk for rebleed[11]
  • increased risk of bleeding increases with age[12]*

* proton pump inhibitor should be given to patients > 75 years of age[12]

  • drug adverse effects of antiplatelet agents
  • drug adverse effects of antithrombotic agent(s)

Mechanism of action

Notes

More general terms

More specific terms

Additional terms

References

  1. ↑ Hallas J et al, Use of single and combined antithrombotic therapy and risk of serious upper gastrointestinal bleeding: Population based case-control study. BMJ 2006, 333:726 PMID: https://pubmed.ncbi.nlm.nih.gov/16984924
    Sung JJY Combining aspirin with antithrombotic agents. BMJ 2006, 333:712 PMID: https://pubmed.ncbi.nlm.nih.gov/17023437
  2. ↑ 2.0 2.1 Thijs V et al, Network meta-analysis: Simulatneous meta-analysis of common antiplatelet regimens after transient ischaemic attack or stroke. Eur Heart J 2008, 29:1086 PMID: https://pubmed.ncbi.nlm.nih.gov/18349026
  3. ↑ 3.0 3.1 3.2 Bhatt DL et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Am J Gastroenterol 2008 Nov; 103:2890.
    Bhatt DL et al, ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2008 Oct 28;52(18):1502-17. PMID: https://pubmed.ncbi.nlm.nih.gov/19017521
    Bhatt DL et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation 2008 Oct 28; 118:1894. PMID: https://pubmed.ncbi.nlm.nih.gov/18836135
  4. ↑ McMorran BJ et al. Platelets kill intraerythrocytic malarial parasites and mediate survival to infection. Science 2009 Feb 6; 323:797. PMID: https://pubmed.ncbi.nlm.nih.gov/19197068
  5. ↑ 5.0 5.1 Prescriber's Letter 18(9): 2011 Discontinuing Antiplatelet Agents Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=270919&pb=PRL (subscription needed) http://www.prescribersletter.com
  6. ↑ Prescriber's Letter 18(10): 2011 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=271020&pb=PRL Comparison of Oral Anticoagulants and Antiplatelets (subscription needed) http://www.prescribersletter.com
  7. ↑ 7.0 7.1 Palmer SC Effects of Antiplatelet Therapy on Mortality and Cardiovascular and Bleeding Outcomes in Persons With Chronic Kidney Disease: A Systematic Review and Meta-analysis Ann Intern Med March 20, 2012 156:445-459 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/22431677 <Internet> http://www.annals.org/search?author1=Suetonia+C.+Palmer&sortspec=date&submit=Submit
  8. ↑ 8.0 8.1 Eikelboom JW, Hirsh J, Spencer FA, Baglin TP, Weitz JI. Antiplatelet drugs: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e89S-119S PMID: https://pubmed.ncbi.nlm.nih.gov/22315278
  9. ↑ 9.0 9.1 9.2 9.3 Deprecated Reference
  10. ↑ Prescriber's Letter 21(9): 2014 Comparison of Oral Antiplatelets Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=300909&pb=PRL (subscription needed) http://www.prescribersletter.com
  11. ↑ 11.0 11.1 Zakko L, Rustagi T, Douglas M, Laine L. No benefit from platelet transfusion for gastrointestinal bleeding in patients taking antiplatelet agents. Clin Gastroenterol Hepatol 2016 Jul 24; PMID: https://pubmed.ncbi.nlm.nih.gov/27464591
  12. ↑ 12.0 12.1 12.2 Li L, Geraghty OC, Mehta Z et al Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study. Lancet. Jun 13, 2017 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/26227434 Free full text <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30770-5/fulltext
    Diener HC Preventing major gastrointestinal bleeding in elderly patients. Lancet. Jun 13, 2017 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/28622952 Free Article <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31507-6/fulltext
  13. ↑ Aldhaeefi M, Badreldin HA, Alsuwayyid F, et al. Practical guide for anticoagulant and antiplatelet reversal in clinical practice. Pharmacy (Basel). 2023;11. PMID: https://pubmed.ncbi.nlm.nih.gov/36827672
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