126 lines
No EOL
33 KiB
XML
126 lines
No EOL
33 KiB
XML
<?xml version="1.0" encoding="utf-8"?>
|
|
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
|
|
|
|
<head><meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
|
|
<!-- AppResources meta begin -->
|
|
<meta name="paf-app-resources" content="" />
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- AppResources meta end -->
|
|
|
|
<!-- TemplateResources meta begin -->
|
|
<meta name="paf_template" content="" />
|
|
|
|
<!-- TemplateResources meta end -->
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books" /><meta name="ncbi_pdid" content="book-part" /><meta name="ncbi_acc" content="NBK537062" /><meta name="ncbi_domain" content="statpearls" /><meta name="ncbi_report" content="printable" /><meta name="ncbi_type" content="fulltext" /><meta name="ncbi_objectid" content="" /><meta name="ncbi_pcid" content="/NBK537062/?report=printable" /><meta name="ncbi_app" content="bookshelf" />
|
|
<!-- Logger end -->
|
|
|
|
<title>Antiplatelet Medications - StatPearls - NCBI Bookshelf</title>
|
|
|
|
<!-- AppResources external_resources begin -->
|
|
<link rel="stylesheet" href="/core/jig/1.15.2/css/jig.min.css" /><script type="text/javascript" src="/core/jig/1.15.2/js/jig.min.js"></script>
|
|
|
|
<!-- AppResources external_resources end -->
|
|
|
|
<!-- Page meta begin -->
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="StatPearls [Internet]" /><meta name="citation_title" content="Antiplatelet Medications" /><meta name="citation_publisher" content="StatPearls Publishing" /><meta name="citation_date" content="2022/11/07" /><meta name="citation_author" content="Arshad Muhammad Iqbal" /><meta name="citation_author" content="Richard A. Lopez" /><meta name="citation_author" content="Ofek Hai" /><meta name="citation_pmid" content="30725747" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK537062/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Antiplatelet Medications" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="StatPearls Publishing" /><meta name="DC.Contributor" content="Arshad Muhammad Iqbal" /><meta name="DC.Contributor" content="Richard A. Lopez" /><meta name="DC.Contributor" content="Ofek Hai" /><meta name="DC.Date" content="2022/11/07" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK537062/" /><meta name="description" content="Over time, numerous antiplatelet agents have been developed with many indications. Antiplatelet medications divide into oral and parenteral agents, and oral agents subdivide further based on the mechanism of action. Aspirin was the first antiplatelet medication and is a cyclooxygenase inhibitor. Other oral antiplatelet include clopidogrel, ticagrelor, and prasugrel, cilostazol, and dipyridamole. Glycoprotein IIb/IIIa inhibitors such as tirofiban and eptifibatide are only available as parenteral agents and are used in acute phases of acute coronary syndrome. This activity reviews the indications, contraindications, actions, adverse events, and other key elements of antiplatelet drugs essential to clinical practice." /><meta name="og:title" content="Antiplatelet Medications" /><meta name="og:type" content="book" /><meta name="og:description" content="Over time, numerous antiplatelet agents have been developed with many indications. Antiplatelet medications divide into oral and parenteral agents, and oral agents subdivide further based on the mechanism of action. Aspirin was the first antiplatelet medication and is a cyclooxygenase inhibitor. Other oral antiplatelet include clopidogrel, ticagrelor, and prasugrel, cilostazol, and dipyridamole. Glycoprotein IIb/IIIa inhibitors such as tirofiban and eptifibatide are only available as parenteral agents and are used in acute phases of acute coronary syndrome. This activity reviews the indications, contraindications, actions, adverse events, and other key elements of antiplatelet drugs essential to clinical practice." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK537062/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-statpearls-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/statpearls/article-17708/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK537062/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
|
|
|
|
<!-- Page meta end -->
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico" /><meta name="ncbi_phid" content="CE8B1C4F7D870251000000000148011F.m_5" />
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3985586/3808861/4121862/3974050/3917732/251717/4216701/14534/45193/4113719/3849091/3984811/3751656/4033350/3840896/3577051/3852958/3984801/12930/3964959.css" /><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3411343/3882866.css" media="print" /></head>
|
|
<body class="book-part">
|
|
<div class="grid no_max_width">
|
|
<div class="col twelve_col nomargin shadow">
|
|
<!-- System messages like service outage or JS required; this is handled by the TemplateResources portlet -->
|
|
<div class="sysmessages">
|
|
<noscript>
|
|
<p class="nojs">
|
|
<strong>Warning:</strong>
|
|
The NCBI web site requires JavaScript to function.
|
|
<a href="/guide/browsers/#enablejs" title="Learn how to enable JavaScript" target="_blank">more...</a>
|
|
</p>
|
|
</noscript>
|
|
</div>
|
|
<!--/.sysmessage-->
|
|
<div class="wrap">
|
|
<div class="page">
|
|
<div class="top">
|
|
|
|
<div class="header">
|
|
|
|
|
|
</div>
|
|
|
|
|
|
|
|
<!--<component id="Page" label="headcontent"/>-->
|
|
|
|
</div>
|
|
<div class="content">
|
|
<!-- site messages -->
|
|
<div class="container content">
|
|
<div class="document">
|
|
<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. </p></div></div></div>
|
|
<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK537062_"><span class="title" itemprop="name">Antiplatelet Medications</span></h1><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Arshad Muhammad Iqbal</span><sup>1</sup>; <span itemprop="author">Richard A. Lopez</span><sup>2</sup>; <span itemprop="author">Ofek Hai</span><sup>3</sup>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> Oak Hill Hospital, Brooksville, FL</div><div class="affiliation"><sup>2</sup> Geisinger Medical Center</div><div class="affiliation"><sup>3</sup> Nassau University Medical Center</div><p class="small">Last Update: <span itemprop="dateModified">November 7, 2022</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="article-17708.s1"><h2 id="_article-17708_s1_">Continuing Education Activity</h2><p>Over time, numerous antiplatelet agents have been developed with many indications. Antiplatelet medications divide into oral and parenteral agents, and oral agents subdivide further based on the mechanism of action. Aspirin was the first antiplatelet medication and is a cyclooxygenase inhibitor. Other oral antiplatelet include clopidogrel, ticagrelor, and prasugrel, cilostazol, and dipyridamole. Glycoprotein IIb/IIIa inhibitors such as tirofiban and eptifibatide are only available as parenteral agents and are used in acute phases of acute coronary syndrome. This activity reviews the indications, contraindications, actions, adverse events, and other key elements of antiplatelet drugs essential to clinical practice.</p><p>
|
|
<b>Objectives:</b>
|
|
<ul><li class="half_rhythm"><div>Determine the mechanisms of action of the different antiplatelet agents.</div></li><li class="half_rhythm"><div>Identify the appropriate indications for the various antiplatelet drugs.</div></li><li class="half_rhythm"><div>Assess the potential adverse event profiles of the different antiplatelet agents.</div></li><li class="half_rhythm"><div>Communicate interprofessional team strategies for improving care coordination and communication to enhance patient outcomes and minimize adverse events with antiplatelet medications.</div></li></ul>
|
|
<a href="https://www.statpearls.com/account/trialuserreg/?articleid=17708&utm_source=pubmed&utm_campaign=reviews&utm_content=17708" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Access free multiple choice questions on this topic.</a>
|
|
</p></div><div id="article-17708.s2"><h2 id="_article-17708_s2_">Indications</h2><p>Antiplatelet medications are divided into oral and parenteral agents. Oral agents subdivide further based on the mechanism of action. Aspirin was the first antiplatelet medication and is a cyclooxygenase inhibitor. Other oral antiplatelet agents include clopidogrel, ticagrelor, prasugrel, pentoxifylline, cilostazol, and dipyridamole. Glycoprotein IIb/IIIa inhibitors such as tirofiban and eptifibatide are only available as parenteral agents and are used in acute coronary syndrome (ACS).<a class="bk_pop" href="#article-17708.r1">[1]</a></p><p>The following is a list of indications of antiplatelet medications: </p><ul><li class="half_rhythm"><div>Acute coronary syndrome</div></li><li class="half_rhythm"><div>Post-percutaneous coronary intervention (PCI) with stenting</div></li><li class="half_rhythm"><div>Mechanical heart valves in combination with warfarin</div></li><li class="half_rhythm"><div>Acute ischemic stroke</div></li><li class="half_rhythm"><div>Post-percutaneous intervention of peripheral arterial disease</div></li><li class="half_rhythm"><div>Device closure of an atrial septal defect (ASD) for at least 6 months</div></li><li class="half_rhythm"><div>Stable angina</div></li><li class="half_rhythm"><div>Post-coronary artery bypass grafting surgery</div></li><li class="half_rhythm"><div>Essential thrombocytosis</div></li><li class="half_rhythm"><div>Primary prevention of coronary artery disease</div></li><li class="half_rhythm"><div>Prevention of colon cancer</div></li><li class="half_rhythm"><div>Kawasaki disease</div></li><li class="half_rhythm"><div>Acute rheumatic disease</div></li><li class="half_rhythm"><div>Post patent ductus arteriosus (PDA) device closure for the first 6 months</div></li><li class="half_rhythm"><div>Acute pericarditis</div></li><li class="half_rhythm"><div>Atrial fibrillation with a high risk of stroke</div></li><li class="half_rhythm"><div>Primary prevention of venous thromboembolism</div></li></ul></div><div id="article-17708.s3"><h2 id="_article-17708_s3_">Mechanism of Action</h2><p>Antiplatelets can be classified based on the mechanism of action as follows:</p><ul><li class="half_rhythm"><div>Platelet aggregation inhibitors such as;
|
|
<ul><li class="half_rhythm"><div>Aspirin and related cyclooxygenase inhibitors</div></li><li class="half_rhythm"><div>Oral thienopyridines such as clopidogrel, ticagrelor, and prasugrel</div></li></ul>
|
|
</div></li><li class="half_rhythm"><div>Glycoprotein platelet inhibitors (eg, abciximab, eptifibatide, tirofiban)</div></li><li class="half_rhythm"><div>Protease-activated receptor-1 antagonists (eg, vorapaxar)</div></li><li class="half_rhythm"><div>Miscellaneous (eg, dipyridamole - a nucleoside transport inhibitor and phosphodiesterase type 3 (PDE3) inhibitor, cilostazol - also a PDE3 inhibitor) <a class="bk_pop" href="#article-17708.r2">[2]</a><a class="bk_pop" href="#article-17708.r3">[3]</a></div></li></ul><p>Aspirin is the most commonly used oral antiplatelet drug. It irreversibly inhibits the cyclooxygenase enzyme (COX) activity in the prostaglandin synthesis pathway (PGH2). This prostaglandin is a precursor of thromboxane A2 (TXA2) and PGI2. Thromboxane A2 works by inducing platelet aggregation and vasoconstriction, and COX-1 mediates its production, while PGI2 works by inhibiting platelet aggregation, induces vasodilation, and is mediated by COX-2. Low-dose aspirin (75 mg to 150 mg) can induce complete or near-complete inhibition of COX-1, thus inhibiting the production of TXA2, while larger doses are required to inhibit COX-2.<a class="bk_pop" href="#article-17708.r4">[4]</a></p><p>Oral thienopyridines selectively inhibit adenosine diphosphate-induced (ADP-induced) platelet aggregation. These drugs are converted into active drugs with the help of the hepatic CYP450 system that can irreversibly inhibit the platelet P2Y12 receptor. Prasugrel is the most potent of all 3 drugs, has a rapid onset of action, and is superior to clopidogrel in patients undergoing coronary stenting. Cangrelor is a new intravenous, reversible P2Y12 receptor antagonist with a rapid onset of action. It achieves a significant degree of platelet inhibition compared with clopidogrel.<a class="bk_pop" href="#article-17708.r5">[5]</a></p><p>Glycoprotein platelet inhibitors work by inhibiting glycoprotein IIb/IIIa (GpIIb-IIIa) receptors on platelets, thus decreasing platelet aggregation. They are most commonly used in ACS.[3] These drugs are only available in an intravenous form and are, therefore, used as short-term therapy.</p><p>Dipyridamole has antiplatelet and vasodilating properties and inhibits platelet cyclic nucleotide phosphodiesterase. This enzyme is responsible for adenosine monophosphate (AMP) degradation to 5'AMP, which increases intra-platelet cyclic AMP accumulation and inhibits platelet aggregation. It also blocks the uptake of adenosine by the platelets, increasing cyclic AMP.<a class="bk_pop" href="#article-17708.r6">[6]</a></p><p>Cilostazol is also reported to have vasodilatory, antiplatelet properties, and antiproliferative effects. It also reduces smooth muscle cell hyperproliferation and intimal hyperplasia after an injury to the endothelium.<a class="bk_pop" href="#article-17708.r7">[7]</a></p></div><div id="article-17708.s4"><h2 id="_article-17708_s4_">Administration</h2><p>Antiplatelet agent administration can be via oral, rectal, or intravenous routes. Oral medications include aspirin, clopidogrel, ticagrelor, cilostazol, and dipyridamole. Intravenous drugs include GpII-IIIA inhibitors and can be used for a short period, most commonly during acute coronary syndromes before or during PCI. Aspirin is available as a rectal suppository if the patient cannot take the drug orally. The articles for each drug on the Statpearls platform cover individual agent dosing. The reader is advised to seek those articles out for specific dosing information.</p></div><div id="article-17708.s5"><h2 id="_article-17708_s5_">Adverse Effects</h2><p>The following are the most common adverse effects associated with antiplatelet medications:</p><ul><li class="half_rhythm"><div>Aspirin-induced asthma</div></li><li class="half_rhythm"><div>Nasal polyps</div></li><li class="half_rhythm"><div>Upper gastrointestinal bleeding because of chronic gastritis</div></li><li class="half_rhythm"><div>Ecchymosis</div></li><li class="half_rhythm"><div>Hematuria</div></li><li class="half_rhythm"><div>Epistaxis</div></li><li class="half_rhythm"><div>Ticagrelor-related dyspnea</div></li><li class="half_rhythm"><div>Hemorrhage</div></li><li class="half_rhythm"><div>Thrombocytopenia <a class="bk_pop" href="#article-17708.r8">[8]</a></div></li></ul><p>Cilostazol's most common side effects are headache, nausea, diarrhea, pain, infection, upper respiratory symptoms, palpitations, arrhythmias, and peripheral edema.</p></div><div id="article-17708.s6"><h2 id="_article-17708_s6_">Contraindications</h2><p>The most common contraindications for using antiplatelet agents are as follows:</p><ul><li class="half_rhythm"><div>Large esophageal varices</div></li><li class="half_rhythm"><div>Recent stroke within 2 years</div></li><li class="half_rhythm"><div>History of intracranial hemorrhage </div></li><li class="half_rhythm"><div>Significant thrombocytopenia </div></li><li class="half_rhythm"><div>Major surgery within 72 hours</div></li><li class="half_rhythm"><div>Hypersensitivity to the medication</div></li><li class="half_rhythm"><div>Acute clinically significant bleed</div></li><li class="half_rhythm"><div>End-stage renal disease on hemodialysis </div></li><li class="half_rhythm"><div>Decompensated liver cirrhosis </div></li><li class="half_rhythm"><div>Severe hypertension with a BP over 200/110 mmHg</div></li><li class="half_rhythm"><div>Congestive heart failure is a contraindication for the use of cilostazol <a class="bk_pop" href="#article-17708.r9">[9]</a></div></li></ul></div><div id="article-17708.s7"><h2 id="_article-17708_s7_">Monitoring</h2><p>Before starting antiplatelet agents, the patient should undergo an assessment for bleeding risk. Advanced age, female gender, and impaired renal function are important factors. The patient should know antiplatelet agents' risks, benefits, and alternatives. Monitoring is generally not required for antiplatelet medications; however, if bleeding is present, bleeding time is helpful to determine if a platelet transfusion is needed or if the medication requires discontinuation. In life-threatening bleeding, such as massive upper gastrointestinal bleeding, the clinician should stop the drug as soon as possible. If the antiplatelet is an essential therapy, such as in post-coronary stenting patients, the medications should be resumed as quickly as safely possible.</p><p>The use of concomitant anticoagulants should be minimized as much as possible, as they increase the risk of bleeding by many times. Clopidogrel and ticagrelor should be discontinued for at least 5 days, and prasugrel should be discontinued for at least 7 days before major cardiac or non-cardiac surgery.</p></div><div id="article-17708.s8"><h2 id="_article-17708_s8_">Toxicity</h2><p>Aspirin is the most commonly used of all antiplatelet drugs, so accidental intake is common. The effect can be life-threatening if taken over 150 mg/kg of body weight. Supportive measures to decrease the absorption of the drug are achievable by using activated charcoal, but only if administered within 4 hours of ingestion. The patient needs monitoring for signs and symptoms of bleeding and the development of metabolic derangements, such as acidosis. If acidosis develops, immediate dialysis is indicated.<a class="bk_pop" href="#article-17708.r10">[10]</a> No antidote is available for most of these drugs; however, a monoclonal antibody against ticagrelor is in development, but it is not commercially available yet.</p></div><div id="article-17708.s9"><h2 id="_article-17708_s9_">Enhancing Healthcare Team Outcomes </h2><p>Antiplatelet drug therapy requires an interprofessional team approach, including clinicians (MDs, DOs, NPs, PAs), specialty-trained nurses, and pharmacists. To achieve optimal patient results, these professionals must collaborate and engage in open communication.</p><p>The choice of an antiplatelet agent depends on the clinical situation. Because of the availability of many antiplatelet agents, the ordering/prescribing clinician should consult with a cardiology or pharmacotherapy specialized pharmacist. When prescribing these agents, the pharmacist should review the patient's medication list and past diagnoses to determine if specific agents are recommended or contraindicated. Communication between the clinical provider and the pharmacists is essential to minimize adverse patient outcomes when using these drugs. A cardiac pharmacist can offer direction regarding agent selection, drug-drug interactions, dose verification, and medication reconciliation for high-risk patients.</p><p>The role of the cardiac nurse administering these medications in the acute setting involves monitoring for any acute adverse symptoms. Prompt communication by the astute nursing staff of an adverse reaction or a complication can significantly reduce patient morbidity and mortality.</p><p>Nurses are often the first healthcare providers to verify these agents' therapeutic effectiveness and monitor for adverse effects. This role becomes crucial in patients receiving dual antiplatelet therapy, as is often the case for preventing stent thrombosis or after an ACS event. The specialty-trained clinicians educate the patient on possible complications, the indications for the prescribed therapy, and the need for adherence to the medication treatment regimen. The nurse should communicate with the clinical provider and the pharmacist if noting any adverse reaction or if there is a concern for patient adherence to drug therapy so that alternative therapies can be considered. An interprofessional approach, with a multifaceted and targeted approach to treatment, is necessary to improve patient outcomes with antiplatelet medications.</p></div><div id="article-17708.s10"><h2 id="_article-17708_s10_">Review Questions</h2><ul><li class="half_rhythm"><div>
|
|
<a href="https://www.statpearls.com/account/trialuserreg/?articleid=17708&utm_source=pubmed&utm_campaign=reviews&utm_content=17708" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Access free multiple choice questions on this topic.</a>
|
|
</div></li><li class="half_rhythm"><div>
|
|
<a href="https://www.statpearls.com/articlelibrary/commentarticle/17708/?utm_source=pubmed&utm_campaign=comments&utm_content=17708" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Comment on this article.</a>
|
|
</div></li></ul></div><div id="article-17708.s11"><h2 id="_article-17708_s11_">References</h2><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="article-17708.r1">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. <span><span class="ref-journal">Chest. </span>2012 Feb;<span class="ref-vol">141</span>(2 Suppl):e89S-e119S.</span> [<a href="/pmc/articles/PMC3278069/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3278069</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22315278" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22315278</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="article-17708.r2">Krötz F, Sohn HY, Klauss V. Antiplatelet drugs in cardiological practice: established strategies and new developments. <span><span class="ref-journal">Vasc Health Risk Manag. </span>2008;<span class="ref-vol">4</span>(3):637-45.</span> [<a href="/pmc/articles/PMC2515423/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2515423</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18827913" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18827913</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="article-17708.r3">Hashemzadeh M, Furukawa M, Goldsberry S, Movahed MR. Chemical structures and mode of action of intravenous glycoprotein IIb/IIIa receptor blockers: A review. <span><span class="ref-journal">Exp Clin Cardiol. </span>2008 Winter;<span class="ref-vol">13</span>(4):192-7.</span> [<a href="/pmc/articles/PMC2663484/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2663484</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19343166" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19343166</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="article-17708.r4">Warner TD, Nylander S, Whatling C. Anti-platelet therapy: cyclo-oxygenase inhibition and the use of aspirin with particular regard to dual anti-platelet therapy. <span><span class="ref-journal">Br J Clin Pharmacol. </span>2011 Oct;<span class="ref-vol">72</span>(4):619-33.</span> [<a href="/pmc/articles/PMC3195738/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3195738</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21320154" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21320154</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="article-17708.r5">Kubica J, Kozinski M, Navarese EP, Tantry U, Kubica A, Siller-Matula JM, Jeong YH, Fabiszak T, Andruszkiewicz A, Gurbel PA. Cangrelor: an emerging therapeutic option for patients with coronary artery disease. <span><span class="ref-journal">Curr Med Res Opin. </span>2014 May;<span class="ref-vol">30</span>(5):813-28.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/24393016" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24393016</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="article-17708.r6">Harker LA, Kadatz RA. Mechanism of action of dipyridamole. <span><span class="ref-journal">Thromb Res Suppl. </span>1983;<span class="ref-vol">4</span>:39-46.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/6356465" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6356465</span></a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="article-17708.r7">Goto S. Cilostazol: potential mechanism of action for antithrombotic effects accompanied by a low rate of bleeding. <span><span class="ref-journal">Atheroscler Suppl. </span>2005 Dec 15;<span class="ref-vol">6</span>(4):3-11.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/16275169" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16275169</span></a>]</div></dd><dt>8.</dt><dd><div class="bk_ref" id="article-17708.r8">Kalyanasundaram A, Lincoff AM., Medscape. Managing adverse effects and drug-drug interactions of antiplatelet agents. <span><span class="ref-journal">Nat Rev Cardiol. </span>2011 Sep 13;<span class="ref-vol">8</span>(10):592-600.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/21912415" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21912415</span></a>]</div></dd><dt>9.</dt><dd><div class="bk_ref" id="article-17708.r9">Barnes GD, Stanislawski MA, Liu W, Barón AE, Armstrong EJ, Ho PM, Klein A, Maddox TM, Nallamothu BK, Rumsfeld JS, Tsai TT, Bradley SM. Use of Contraindicated Antiplatelet Medications in the Setting of Percutaneous Coronary Intervention: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program. <span><span class="ref-journal">Circ Cardiovasc Qual Outcomes. </span>2016 Jul;<span class="ref-vol">9</span>(4):406-13.</span> [<a href="/pmc/articles/PMC4956561/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4956561</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27245070" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27245070</span></a>]</div></dd><dt>10.</dt><dd><div class="bk_ref" id="article-17708.r10">Dargan PI, Wallace CI, Jones AL. An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose. <span><span class="ref-journal">Emerg Med J. </span>2002 May;<span class="ref-vol">19</span>(3):206-9.</span> [<a href="/pmc/articles/PMC1725844/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1725844</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11971828" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11971828</span></a>]</div></dd></dl></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin">
|
|
<b>Disclosure: </b>Arshad Muhammad Iqbal declares no relevant financial relationships with ineligible companies.</p></div></dd><dt></dt><dd><div><p class="no_top_margin">
|
|
<b>Disclosure: </b>Richard Lopez declares no relevant financial relationships with ineligible companies.</p></div></dd><dt></dt><dd><div><p class="no_top_margin">
|
|
<b>Disclosure: </b>Ofek Hai declares no relevant financial relationships with ineligible companies.</p></div></dd></dl></div></div></div>
|
|
<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2025, StatPearls Publishing LLC.<p class="small">
|
|
This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
|
|
(<a href="https://creativecommons.org/licenses/by-nc-nd/4.0/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=uri">
|
|
http://creativecommons.org/licenses/by-nc-nd/4.0/
|
|
</a>), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.
|
|
</p></div><div class="small"><span class="label">Bookshelf ID: NBK537062</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/30725747" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">30725747</a></span></div></div></div>
|
|
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="bottom">
|
|
|
|
<div id="NCBIFooter_dynamic">
|
|
<!--<component id="Breadcrumbs" label="breadcrumbs"/>
|
|
<component id="Breadcrumbs" label="helpdesk"/>-->
|
|
|
|
</div>
|
|
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </script>
|
|
</div>
|
|
</div>
|
|
<!--/.page-->
|
|
</div>
|
|
<!--/.wrap-->
|
|
</div><!-- /.twelve_col -->
|
|
</div>
|
|
<!-- /.grid -->
|
|
|
|
<span class="PAFAppResources"></span>
|
|
|
|
<!-- BESelector tab -->
|
|
|
|
|
|
|
|
<noscript><img alt="statistics" src="/stat?jsdisabled=true&ncbi_db=books&ncbi_pdid=book-part&ncbi_acc=NBK537062&ncbi_domain=statpearls&ncbi_report=printable&ncbi_type=fulltext&ncbi_objectid=&ncbi_pcid=/NBK537062/?report=printable&ncbi_app=bookshelf" /></noscript>
|
|
|
|
|
|
<!-- usually for JS scripts at page bottom -->
|
|
<!--<component id="PageFixtures" label="styles"></component>-->
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal104 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3879255/4121861/3501987/4008961/3893018/3821238/3400083/3426610.js" snapshot="books"></script></body>
|
|
</html> |