Antithrombotic drugs: list, classification, action and reviews

In the treatment of patients with cardiac diseases, doctors focus on the use of antianginal as well as antihypertensive and antiarrhythmic drugs.

According to large multicenter studies, these drugs significantly affect the incidence of myocardial infarction, stroke, deep vein thrombosis, and improve the quality and life expectancy of patients with cardiovascular diseases.

The use of modern antithrombotic drugs, in particular, antagonists of nerve endings IIb / Sha, presents additional opportunities for improving the results of therapy for thrombosis or thromboembolism.

Large reserves are also made in optimizing the use of traditional antithrombotic drugs.

Classification of antithrombotic drugs in tablets and ampoules

To prevent and eliminate thrombosis, three main groups are used:

Antiplatelet agents:

1. "Aspirin".
2. "Dipyridamole".
3. Indobufen.
4. Ticlopidine.
5. "Clopidogrel."

In addition, the classification of antithrombotic drugs is supplemented by angiotensin receptor inhibitors:

1. Lamifiban
2. Integrilin.

Anticoagulants:

1. "Heparin."
2. Dalteparin.
3. Nadroparin.
4. "Parnoparin".
5. Reviparin.
6. Enoxaparin.
7. Sulodexide.

Direct thrombin inhibitors are Hirudin.

Indirect:

1. "Acenocumarol".
2. "Coumarin".
3. Fenindion.

The mechanism of action of antithrombotic drugs appears in the blockade of receptors on the membrane of blood clots. The active substance inhibits platelet aggregation, as a result, the binding of adenosine triphosphate to their nerve endings is blocked.

When using such medications, blood coagulation decreases and its rheological properties improve.

Indications for the use of antithrombotic drugs:

1. Hypertension (a disease in which sustained high blood pressure is noted).
2. Coronary heart disease (organic and functional diseases of the heart muscles, which is provoked by a deficiency or termination of myocardial microcirculation).
3. Violation of microcirculation in the vessels of the brain.
4. Pathological processes in the vessels of the lower extremities.
5. Transient ischemic attack (acute transient violation of the microcirculation of the brain by ischemia, an episode of neurological disorders that are provoked by ischemia of a part of the brain or spinal cord).
6. Thrombophlebitis (a disease with inflammatory lesions of the vein wall and the formation of blood clots that close its lumen).
7. Stroke (an acute violation of the microcirculation of the brain, which leads to a persistent source of brain damage).
8. Retinopathy in diabetes mellitus (damage to the retina of the eyeball of any origin).

In addition, these drugs are used for prophylactic purposes to prevent stroke, before or after surgery, stenting, as well as angioplasty or coronary artery bypass grafting. A cardiologist, as well as a neurologist and phlebologist can prescribe the use of such drugs.

The disadvantages of antithrombotic drugs that dissolve a blood clot include a large number of limitations.

Contraindications

Medicines have certain limitations, for example:

1. Gastric and duodenal ulcer during exacerbation.
2. Diseases that are characterized by an increased likelihood of bleeding.
3. Hemorrhagic diathesis (a group of diseases in which there is an increased tendency to subcutaneous hemorrhage and bleeding).
4. Chronic kidney disease.
5. Hemorrhagic stroke (a disease associated with hemorrhage in the brain or under its shell and leading to very serious consequences).
6. Impaired liver function.
7. Bronchial asthma (inflammatory damage to the respiratory system involving a variety of cellular elements).
8. Kidney disease.
9. Terminal heart failure (impaired myocardial ability to contract and the occurrence of stagnation in the large or small circle of blood circulation).
10. Stroke of hemorrhagic origin (acute violation of microcirculation of the brain with a breakthrough of blood vessels and cerebral hemorrhage).
11. During pregnancy.
12. Breast-feeding.

In all these situations, you should stop taking antiplatelet agents and choose other methods for treating a person. In addition, each individual group of medicines has additional restrictions, which it is important to consult a doctor or in the instructions for use.

Side effects of antithrombotic drugs:

• dyspeptic phenomena;
• vomiting
• allergic reactions;
• leukopenia;
• hair loss;
• feeling dizzy.

If such signs appear, you should contact a medical specialist.

The rest of the article will review antithrombotic drugs. The projects of the two companies were among the winners. So, the “Innovative anti-inflammatory drug - inhibitor of inducible NO synthase” of the company “Polar” and “Innovative antithrombotic medication GRS” (LLC “Proton”) won prizes.

It should be noted that preclinical studies were completed on both projects, and the go-ahead for receiving the first phase of clinical trials was received from the Russian Ministry of Health for the production of antithrombotic drugs.

The developed antithrombotic drug GRS suppresses aggregation of blood platelets:

1. Created based on GRS.
2. New drug - considered an activator of soluble guanylate cyclase.
3. The document confirming the exclusive right belongs to Russia, the USA, the EU.

Used for prophylactic purposes to prevent atherothrombosis and its complications in the presence of risk factors (atherosclerosis, hypertension, diabetes mellitus, obesity, smoking, retirement age). And also, the drug is effective in preventing thromboembolism after surgery on the vessels. It is possible to take both a single medicine, and as part of a complex treatment with acetylsalicylic acid.

Key benefits:

1. A unique combination of antiaggregant, antihypertensive and cardioprotective effects.
2. The absence of negative effects on the digestive tract.
3. Minimal risk of drug interactions (GRS is not metabolized by cytochrome P450-dependent monooxygenase and does not inhibit their activity).
4. High therapeutic index (one to two orders of magnitude higher than that of known antithrombotic agents).
5. Safe for long use.

List of antithrombotic drugs

List of effective:

1. "Aspirin".
2. Chimes.
3. Ibustrin.
4. "Tiklid."
5. "Plavike."
6. Lamifiban
7. Integrilin.
8. Fragmin.
9. "Fraxinarine".
10. "Fluxum".
11. Klivarin.
12. Clexane.
13. "Wessel Douai F".
14. Lepirudin.
15. Sinkumar.
16. Warfarin.
17. Fenilin.

Next, the most effective and best antithrombotic drugs on the list will be considered.

"Aspirin"

In most cases, medical experts advise to include this drug for thrombosis in combination therapy. This medication is used to eliminate the problems of thrombosis - a strong blood density.

Using these properties, acetylsalicylic acid helps dissolve clots that are present in the lumen of the veins, and also helps prevent the formation of new blood clots.

Acetylsalicylic acid ("Aspirin") refers to non-steroidal anti-inflammatory drugs. In addition, the drug has an antipyretic and analgesic effect, and therefore the scope of its use is quite extensive.

By the eighties of the last century, researchers found that Aspirin dissolves blood clots, and also helps prevent re-thrombosis.

In addition to the blood-thinning effect, acetylsalicylic acid from blood clots helps as follows:

1. Strengthens the internal single-layer layer of flat cells of the mesenchymal origin of capillaries.
2. Prevents the deposition of cholesterol on the walls of veins and blood vessels.
3. Helps to evenly expand the vascular lumen.

Medical specialists use the drug for prophylactic purposes to prevent heart attacks, as well as strokes and other serious diseases that arise as a result of vascular thromboembolism of various origins.

When Aspirin is combined with glucocorticosteroids, as well as medicines that contain ethanol and alcohol, the negative effect of acetylsalicylic acid on the mucous membrane of the gastrointestinal tract increases and the likelihood of internal bleeding increases.

Antacids that contain magnesium or aluminum hydroxide impair the absorption of Aspirin from the stomach.

Ticlopidine (Ticlo)

The modern antiplatelet agent that is most effective in contrast to Aspirin. The drug is used to prevent thrombotic complications in people with angina pectoris, as well as ischemic damage to the brain or lower extremities.

The use of the drug is recommended after coronary artery bypass grafting and other operations on the blood vessels.

Due to the pronounced pharmacological effect, such a medication can not be used with other disaggregants and anticoagulants, since this can lead to the appearance of internal bleeding and to adverse reactions. In addition, the drug has a trade name - "Tiklo".

"Clopidogrel"

The drug is considered a synthetic disaggregant, identical in structure and therapeutic activity with "Ticlopidine."

According to the instructions for use with the drug, it is known that the active component quickly blocks the activation of platelets and prevents their aggregation. The main advantage of this medicine is the good tolerance of therapy to most people.

This allows you to use the medication in most clinical situations, without fear of side effects. The main substance of the drug suppresses the process of combining platelets.

When using this medicine, blood liquefies and the bleeding time increases. The best effect after starting treatment can be seen during the first week. The ability for a normal association process resumes one week after discontinuation of therapy.

If a person has an increased likelihood of bleeding after trauma, surgery, or with negative changes in the hemostatic system, caution must be exercised when using Clopidogrel. If the operation is planned and the antiplatelet effect is undesirable, then the medicine should be discontinued a week before surgery.

The drug is prescribed with extreme caution to patients suffering from impaired liver function in a severe form, who are at risk of hemorrhagic origin of diathesis.

In a situation if there are symptoms of increased bleeding, you need to examine the hemostatic system. In addition, it is necessary to regularly monitor laboratory parameters of the liver.

"Dipyridamole"

A drug that has a complex effect on the hematopoiesis system. The drug dilates the coronary vessels, increases myocardial contractility and improves blood flow through the venous bed. When using "Dipyridamole" there is a pronounced antiplatelet effect.

A large number of modern medicines leads to the need to visit a medical specialist before starting therapy. The selection of each drug is carried out taking into account the characteristics of the patient's body.

The drug "Dipyridamole" is considered an antiplatelet agent and an angioprotector. It has a positive effect on capillaries, eliminates congestion, improves blood circulation. Marked beneficial effect on the vessels of the muscles of the heart, prevents the occurrence of ischemic conditions of the brain. The active component of "Dipyridamole" somewhat expands the capillaries, thereby increasing the volumetric velocity of coronary blood flow.

The medication reduces the process of platelet aggregation and blood viscosity, which serves to prevent the appearance of thrombosis, as well as varicose veins and hemorrhoids.

In addition to its direct pharmacological effect, the active substance of the drug activates the production of interferon by the body, with the help of which patients who use Dipyridamole increase their resistance to viral diseases and strengthen their immunity.

Fraxiparin

The medication is intended only for subcutaneous injection, intramuscular use of the drug is contraindicated. During therapy with "Fraxiparin", the patient must constantly monitor the level of platelets in the blood, and if they are greatly reduced, then the treatment is stopped.

In a patient of retirement age, the likelihood of side effects is significantly higher than in young people, therefore, during therapy, you need to constantly monitor the general condition of the patient.

"Fraxiparin" can inhibit the production of aldosterone, which leads to an increase in potassium levels in the blood, especially people with diabetes, as well as metabolic acidosis or chronic kidney disease.

The medication has no effect on the functioning of the central nervous system and does not suppress the speed of psychomotor reactions.

Curantil

The main active component of the drug slows down the process of gluing platelets and improves blood circulation. Curantil, when taken orally in large doses, expands even the smallest capillaries, but an increase in large vessels, unlike calcium antagonist drugs, is not observed, and blood pressure indicators remain normal.

The active substance is considered a pyrimidine derivative and an interferon inducer, therefore, in addition to its main pharmacological action, the drug activates the body's protective functions and increases the body's resistance to viral diseases.

During therapy, "Curantyl" a person needs to refrain from drinking tea and coffee, because against this background, the therapeutic effect of the drug may be reduced.

This medication is not prescribed for persons under the age of twelve due to the lack of clinical experience in the use of the drug in pediatrics. During treatment with Curantil, special care must be taken when driving vehicles and complex mechanisms that require increased attention. Such measures are due to the possibility of reducing blood pressure and dizziness in a patient.

Opinions

According to reviews, medical experts prescribe antithrombotic agents in case of thrombosis and thromboembolism. Preparations effectively cope with the task.

Doctors do not recommend self-medication, since such measures in most cases lead to severe hemorrhagic complications in patients.

There are a lot of reviews about antithrombotic drugs from people who have had serious illnesses and surgeries; they highly appreciate the effect of such drugs, for example, Clopidogrel, Curantil, and Ticlopidine. But their appointment and monitoring of admission should be carried out only by a doctor.