Antiplatelet agents: a list of drugs. Anticoagulants and antiplatelet agents, their characteristics

Increased blood coagulation often causes thrombosis, which leads to dire consequences, including death. Advances in pharmacology can save the lives of patients with this pathology due to maintenance therapy in the form of antiplatelet drugs.

What are anticoagulants?

The rheological properties of blood are ensured by the balance between coagulation and anticoagulant systems. In maintaining this balance, antithrombin III and heparin are involved as natural anticoagulants, which perform a direct antithrombotic function, that is, they 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 the binding of thrombin, making it inactive - this also contributes to the inhibition of thrombosis. Antithrombin III itself also has anticoagulation properties, inactivating thrombin, however, this reaction proceeds very slowly.

The ability of heparin to provide inactivation of thrombin directly depends on the amount of antithrombin III in the blood. A dose adjustment based on analyzes is required. Often, the appointment of two drugs at once is required - heparin and antithrombin III, while dosages are selected individually for each person.

Antithrombin binding is not the only function of heparin. In addition, it is able to cleave fibrin without the participation of plasmin, which is called non-enzymatic lysis. This reaction is associated with the formation of compounds with various biologically active substances, including peptides and hormones. Among other functions, suppression of a number of enzymes, participation 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 are distinguished.

What are antiplatelet agents?

Anticoagulants and antiplatelet agents are effectively used in medicine. This name was given to drugs that suppress the bonding (aggregation) of blood cells - platelets and red blood cells. The mechanism of action of these substances is different, which allowed us to distinguish several groups. Antiplatelet agents, the list of drugs which is extensive, is classified as follows.

1. Calcium Antagonists (Verapamil).
2. Enzyme inhibitors, which include substances that inhibit cyclooxygenase (acetylsalicylic acid, Naproxen, Indomethacin), as well as adenylate cyclase and phosphodiesterase (Ticlopidine, Pentoxifylline).
3. Drugs that stimulate the formation of prostacyclin ("Pyrazolin").
4. Prostanoids ("Prostacyclin" and its analogues of a synthetic nature).
5. Drugs that inhibit the release of substances contained in platelets ("Piracetam").

Indications

Antiplatelet agents - drugs whose names are known to many due to their widespread use. The main function of this group is the prevention of thrombosis. Antiplatelet agents - drugs that are effectively used in a number of cardiovascular pathologies, as well as after surgical operations (prosthetics of heart valves).

Antiplatelet agents: a list of drugs that are often used in medical practice

There are a lot of drugs that belong to this group, and they all have their own characteristics. The selection of a particular medicine depends on the clinical case. And, of course, self-medication is inappropriate in this situation.

"Aspirin"

Eicosanoids, which are a product of the oxidation of arachidonic acid, take part in the regulation of hemostasis. Among them, thromboxane A2 is most important, and its main function is to ensure platelet aggregation. The action of aspirin is aimed at inhibiting the enzyme, which is called cyclooxygenase. As a result of this, the synthesis of tomboxane A2 is suppressed, therefore, thrombus formation processes are inhibited. The effect increases with repeated use of the drug due to cumulation. For complete inhibition of cyclooxygenase, a daily intake is required. The optimal dosage reduces the likelihood of side effects of Aspirin, even with constant use. An increase in dose is unacceptable, since there is a risk of complications in the form of bleeding.

"Ticlopidine"

The effect of the drug is based on blocking certain receptors responsible for thrombosis. Normally, when binding to ADP, a change in the shape of the platelet occurs and aggregation is stimulated, and Ticlopidine inhibits this process. A feature of this antiplatelet agent is its high bioavailability, which is achieved by a high absorption rate. After cancellation, 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.

"Clopidogrel"

The antiplatelet agent is similar in type of action to Ticlopidine, but its advantage is its relatively low toxicity. In addition, the risk of side effects when taking this drug is much lower. Currently, experts prefer Clopidogrel because of the absence of complications in the form of agranulocytosis and thrombocytopenia.

"Eptifibatide"

The drug disrupts aggregation by blocking the glycoprotein, which is located in the platelet membrane. It is prescribed for intravenous jet administration, usually with angina pectoris and angioplasty to reduce the likelihood of myocardial infarction.

"Dipyridamole"

The main effect of the drug is vasodilation, that is, vasodilation, however, when combined with other drugs, a pronounced antiplatelet effect is observed. Dipyridamole is prescribed together with Aspirin if there is a high risk of thrombosis. A combination with Warfarin is also possible, which is effectively used after prosthetic heart valves to reduce the likelihood of embolism. With monotherapy, the effect is less pronounced.

Antiplatelet agents - drugs (list: "Elikvis", "Clopidogrel" and others), widely used in practice.

Contraindications

The appointment of antiplatelet agents requires a thorough history taking, which includes information on concomitant pathologies. If there is a disease that is a contraindication for taking drugs of this group, a correction of the treatment plan is necessary. In such cases, an individual selection of funds and their dosages is carried out, and therapy is carried out under the strict supervision of a doctor. In no case is the self-administration of antiplatelet agents allowed, since the consequences can be fatal.

List of contraindications:

• allergy;
• hemorrhagic diathesis;
• risk of bleeding;
• severe liver and kidney failure;
• history of arrhythmias;
• severe arterial hypertension;
• obstructive diseases of the respiratory system;
• children's age (for most drugs).

In addition, many antiplatelet agents (the list of drugs discussed 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.

Antiplatelet agents. Drugs: a list during pregnancy

If the fetal circulation is disturbed, there is a risk of abortion. This phenomenon is called fetoplacental insufficiency. If delivery of oxygen with blood is impaired, severe hypoxia develops in the fetus, which threatens not only deviations in its development, but also death. When diagnosing such a pathology, immediate treatment is required, which consists in improving blood flow, lowering blood viscosity. For this, antiplatelet agents are prescribed, however, it should be remembered that not all drugs in this group are safe during pregnancy. Only certain agents are allowed.

Curantil

The drug is very popular due to the fact that its list of contraindications does not include pregnancy and breastfeeding. The active substance "Curantyl" is the previously described dipyridamole, which dilates blood vessels, and also inhibits thrombosis. The drug improves blood supply to the heart muscle, ensuring the delivery of the necessary amount of oxygen. Due to this, "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 blood and vasodilation, prevention of blockage of the vessels of the placenta is carried out, so the fetus does not suffer from hypoxia. An additional advantage of the drug can be called an immunomodulatory effect. The drug stimulates the production of interferon, resulting in a reduced risk of developing maternal viral diseases. Although Curantil can be used during pregnancy and lactation, it should only be prescribed if indicated. When taking the drug should reduce the consumption of tea and coffee, as they reduce its effectiveness. Antiplatelet agents - drugs (list above) that should not be combined with such drinks. Although during pregnancy they are not advised to get involved in any case.

Antiplatelet agents, the list of drugs which includes dozens of names, are effectively used in the treatment of diseases of the cardiovascular system. However, you should be aware of the possible complications associated with reduced blood viscosity and suppression of coagulation. Antiplatelet agents - drugs that can be used only under the supervision of the attending physician, he will select the necessary dosage and course of therapy.