Antiplatelet agents: indications, side effects, risks

2023-04-25 15:25:33

And platelet aggregation inhibitor is a preventive medicine that opposes the aggregation of platelets, the first stage of coagulation sanguinewith the aim of limiting the risk of developing a clotor worsening of atherosclerotic plaques in patients with atherosclerosis. Indeed, these plaques contain lipids, different types of cells, calcium deposits but also blood platelets. They reduce the arterial lumen (stenosis) and expose to a risk of obstruction of the artery (ischemia).

Antiplatelet agents protect against the risk ofischemic accidents as l’AVC, myocardial infarction or the lower extremity arterial thrombosis.

These drugs are often likened to blood thinners and belong to the family of antithrombotics just like the anticoagulants. They work by delaying the agglutination of platelets or by limiting the production of fibrin responsible for the formation of clots. The action of antiplatelet agents is limited to preventing the obstruction of the arteries and not of the veins.

The most well-known antiplatelet agents are acetylsalicylic acid (aspirin) and the clopidrogel ( Plavix®).

What is the difference between antiaggregants and anticoagulants?

Antiplatelet drugs prevent platelets from clumping together, which may form a clot or worsen theatherosclerosis. They are a prevention against atheromatous diseases of the artery such as l’AVC, myocardial infarction or arterial thrombosis of the lower limbs. For their part, anticoagulants have a thinning action on the blood which further protects against venous obstructions (phlebitis, pulmonary embolism) or against the risk of thrombosis secondary to an atrial fibrillation disorder.

It should be added that antiaggregants have certain advantages in comparison with anticoagulants. First of all, their oral administration is simplified. In addition, hemorrhagic complications are rare and clinical monitoring is therefore reduced.

What are the indications for antiplatelet drugs?

Antiplatelet agents are prescribed for the primary or secondary prevention of ischemic atheromas such as:

They are administered to prevent the complications of chronic diseases with cardiovascular risks such as thediabetes, high blood pressure, hypercholesterolemia, metabolic syndrome…

What are antiplatelet drugs?

here is list of antiplatelet agents which may be prescribed:

L’acetylsalicylic acid (Aspirin, Aspegic®, Kardegic®) at low doses (75 mg to 325 mg per day).
The flurbiprofen (Cebu time®), at a dose of 100 mg per day.
The clopidogrel (Plavix®), at a dose of 75 mg per day.
The ticlopidine (Ticlid®) dosed at 250 mg, the adult dosage is one tablet morning and evening.
The dipyridamole (Cleridium®, Persantine®) at an average dose of 300 mg per day.
THE cyclopentyl-triazolo-pyrimidines are reserved for patients requiring coronary intervention or indicated in combination with aspirin (75 to 325 mg per day) in acute coronary insufficiency (unstable angina, myocardial infarction):
- the prasugrel (Efient®) at a dose of 10 mg once daily;
- the ticagrélor (Brilique®) at a dose of 90 mg twice daily.

Note that there are products that combine several of these molecules (Duoplavin®, Asasantine LP®). There are also antiplatelet drugs that can be injected intravenously (Agrastat®, Reopro®, Integrilin®). They are reserved for hospitals and indicated in angioplasties.

Platelet antiaggregants: what contraindications?

Special precautions are necessary in case of:

lesion, wound, trauma;
bleeding disorder, disease or hemorrhagic risk ;
history of allergy to another platelet aggregators;
planned surgery or dental intervention ;
disease caused by a nonsteroidal anti-inflammatory drug (including aspirin): asthma or history of asthma, history of digestive disease (ulcer, haemorrhage, perforation);
active peptic ulcer ;
heart failure ;
Hepatic insufficiency ;
renal failure ;
mastocytose (disease characterized by the abnormal proliferation of mast cells under the effect of a genetic mutation and their accumulation in various organs).

What are the side effects of antiplatelet drugs?

The main side effects are related to the antiaggregating action of the drug, with:

a possible increased bleeding time on even minor injuries (shaving, brushing teeth, etc.);
of the frequent nose bleeds ;
of the bleeding in the stool ;
a delayed wound healing ;
a tendency to formbruises and D’hematomas.

Other effects are possible at varying frequencies:

of the digestive disorders (stomach aches, diarrhoea, nausea, gastritis or even ulcers, etc.);
a transient renal failure ;
liver problems (increase in liver enzymes);
of the Rashes, urticaria ;
of the allergic reactions ;
of the headaches ;
of the gout attacks in predisposed persons;
a hypotension ;
of the dizziness…