In the treatment of patients suffering from cardiac diseases, doctors focus on the use of antianginal, as well as antihypertensive and antiarrhythmic drugs.
According to large multicenter studies, these drugs have a significant impact on the incidence of myocardial infarction, stroke, deep vein thrombosis, improve the quality and life expectancy of patients with cardiovascular disease.
The use of modern antithrombotic drugs, in particular IIb/IIIa nerve ending antagonists, provides additional opportunities to improve the results of therapy for thrombosis or thromboembolism.
Large reserves lie in optimizing the use of traditional antithrombotic drugs.
Classification of antithrombotic drugs intablets and ampoules
Three main groups are used to prevent and eliminate thrombosis:
Antiplatelet agents:
- "Aspirin".
- "Dipyridamole".
- "Indobufen".
- "Ticlopidine".
- "Clopidogrel".
In addition, angiotensin receptor inhibitors supplement the classification of antithrombotic drugs:
- "Lamifiban".
- "Integrilin".
Anticoagulants:
- "Heparin".
- "D alteparin".
- "Nadroparin".
- "Parnoparin".
- "Reviparin".
- "Enoxaparin".
- "Sulodexide".
Direct thrombin inhibitors - "Hirudin".
Indirect:
- "Acenocoumarol".
- "Coumarin".
- "Phenindion".
The mechanism of action of antithrombotic drugs acts 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 medicines, blood clotting decreases and its rheological properties improve.
Indications for use of antithrombotic drugs:
- Hypertension (a disease in which there is sustained high blood pressure).
- Ischemic heart disease (organic and functional diseases of the heart muscles, which is provoked by a deficiency or cessation of myocardial microcirculation).
- Violation of microcirculation in the vessels of the brain.
- Pathological processes in the vessels of the lower extremities.
- Transient ischemic attack (acute transient violation of the microcirculation of the brain due to ischemia, an episode of neurological disorders that are provoked by ischemia of a section of the brain or spinal cord).
- Thrombophlebitis (a disease with an inflammatory lesion of the vein wall and the formation of blood clots that close its lumen).
- Stroke (acute violation of the microcirculation of the brain, which leads to a persistent source of brain damage).
- 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 restrictions, for example:
- Stomach and duodenal ulcer during exacerbation.
- Diseases that are characterized by an increased chance of bleeding.
- Hemorrhagic diathesis(a group of diseases in which there is an increased tendency to subcutaneous hemorrhage and bleeding).
- Chronic kidney disease.
- Hemorrhagic stroke (a disease associated with bleeding in the brain or under its membranes and leading to very serious consequences).
- Liver dysfunction.
- Bronchial asthma (inflammatory lesion of the respiratory organs involving a variety of cellular elements).
- Kidney disease.
- Terminal heart failure (violation of the ability of the myocardium to contract and the occurrence of congestion in the systemic or pulmonary circulation).
- Stroke of hemorrhagic origin (acute violation of the microcirculation of the brain with a breakthrough of blood vessels and hemorrhage in the brain).
- During pregnancy.
- Breastfeeding.
In all these situations, antiplatelet drugs should be discontinued and other methods of treatment of the person should be chosen. In addition, each individual group of medicines has additional restrictions, which it is important to familiarize yourself with the doctor or in the instructions for use.
Side effects of antithrombotic drugs:
- dyspepsia;
- vomit;
- allergic reactions;
- leucopenia;
- hair loss;
- feeling dizzy.
If these signs appear, you should consult a medical specialist.
Further in the article, an overview of antithrombotic drugs will be carried out. Projects of two companieswere among the winners. So, "Innovative anti-inflammatory drug - inhibitor of inducible NO-synthase" company "Poliar" and "Innovative antithrombotic drug GRS" (LLC "Proton") won prizes.
It should be noted that preclinical studies have been completed for both projects, and for the production of an antithrombotic drug, "go-ahead" has been received from the Ministry of He alth of Russia for the implementation of the first phase of clinical trials.
An antithrombotic drug under development, GRS, inhibits platelet aggregation:
- Created from GRS.
- New drug - thought to be a soluble guanylate cyclase activator.
- The document confirming the exclusive right belongs to Russia, USA, 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 for the prevention of thromboembolism after surgical interventions on the vessels. It is possible to take both a single drug and as part of a complex treatment with acetylsalicylic acid.
Key Benefits:
- A unique combination of antiplatelet, antihypertensive and cardioprotective action.
- No negative effect on the digestive tract.
- Minimum risk of drug-drug interactions (GRS is not metabolized by cytochrome P450-dependent monooxygenase and does not inhibit their activity).
- Hightherapeutic index (one to two orders of magnitude higher than that of known antithrombotic agents).
- Safe for long-term use.
List of antithrombotic drugs
List of effective:
- "Aspirin".
- "Curantil".
- "Ibustrin".
- "Tiklid".
- "Plavik".
- "Lamifiban".
- "Integrilin".
- "Fragmin".
- "Fraxinarine".
- "Fluxum".
- "Clivarin".
- "Clexane".
- "Wessel Due F".
- "Lepirudin".
- "Sinkumar".
- "Warfarin".
- "Phenylin".
Next, the most effective and best antithrombotic drugs in the list will be considered.
Aspirin
In most cases, medical experts advise including this drug in combination therapy for thrombosis. This medication is used to treat problems with blood clots - thick blood.
With these properties, acetylsalicylic acid helps to dissolve the clots that are present in the lumen of the veins, and also helps prevent the formation of new blood clots.
Acetylsalicylic acid ("Aspirin") is a non-steroidal anti-inflammatory drug. In addition, the drug has an antipyretic and analgesic effect, and thereforethe scope of its use is quite extensive.
By the 1980s, researchers found that Aspirin dissolved blood clots and also helped prevent re-clotting.
In addition to blood-thinning effects, acetylsalicylic acid from blood clots helps in the following ways:
- Strengthens the inner single-layer layer of flat cells of mesenchymal origin of capillaries.
- Prevents the deposition of cholesterol on the walls of veins and blood vessels.
- 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 occur as a result of thromboembolism of vessels of various origins.
When Aspirin is combined with glucocorticosteroids, as well as medicines that contain ethanol, and alcoholic beverages, 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" ("Tiklo")
Modern antiplatelet agent, which is the most effective in contrast to "Aspirin". The drug is used to prevent thrombotic complications in people with angina pectoris, andalso ischemic damage to the brain or lower extremities.
The use of the drug is recommended after coronary artery bypass grafting and other operations on blood vessels.
Due to the pronounced pharmacological action, such a medication cannot be used with other antiplatelet agents and anticoagulants, as this can lead to internal bleeding and adverse reactions. In addition, the drug has a trade name - "Tiklo".
Clopidogrel
The drug is considered a synthetic antiplatelet agent, identical in structure and therapeutic activity with "Ticlopidine".
According to the instructions for use of the drug, it is known that the active ingredient quickly blocks the activation of platelets and prevents their aggregation. The main advantage of this medicine is that the therapy is well tolerated by most people.
This allows the drug to be used in most clinical situations without fear of side effects. The main substance of the drug inhibits the process of association of platelets.
This medicine thins the blood and increases bleeding time. The best effect after the start of treatment can be seen during the first week. The ability for the normal unification process resumes one week after stopping therapy.
If a person has increasedthe likelihood of bleeding after injury, surgery, or with negative changes in the hemostasis system, then care must be taken when using Clopidogrel. If surgery is planned and the antiplatelet effect is undesirable, then the drug should be canceled a week before surgery.
The drug is prescribed with extreme caution to patients suffering from severe liver dysfunction, who are at risk of diathesis of hemorrhagic origin.
In a situation where there are symptoms of increased bleeding, it is necessary to investigate the hemostasis system. In addition, it is necessary to regularly monitor the laboratory parameters of the liver.
Dipyridamole
A drug that has a complex effect on the hematopoietic system. The drug dilates the coronary vessels, increases myocardial contractility and improves blood flow through the venous bed. When using Dipyridamole, a pronounced antiplatelet effect is observed.
A large number of modern drugs lead 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 angioprotector. It has a positive effect on capillaries, eliminates congestion, improves blood circulation. A beneficial effect onvessels of the muscles of the heart, prevents the occurrence of ischemic conditions of the brain. The active component of "Dipyridamole" slightly expands the capillaries, thereby increasing the volumetric rate of coronary blood flow.
The drug reduces the process of platelet aggregation and blood viscosity, which serves to prevent the occurrence of thrombosis, as well as varicose veins and hemorrhoids.
In addition to its direct pharmacological effect, the active substance of the drug activates the process of producing interferon by the body, with the help of which patients who used Dipyridamole increase resistance to viral diseases and strengthen immunity.
Fraxiparine
The drug is for subcutaneous injection only, intramuscular use of the drug is contraindicated. During therapy with Fraxiparine, the patient must constantly monitor the level of platelets in the blood, and if they have greatly decreased, then the treatment is stopped.
In a patient of retirement age, the likelihood of side effects is much higher than in young people, so during therapy, you need to constantly monitor the general condition of the patient.
Fraxiparine can inhibit the production of aldosterone, which leads to an increase in the level of potassium in the blood, especially for people with diabetes, as well as metabolic acidosis or chronic kidney disease.
The drug has no effecteffects on the functioning of the central nervous system and does not suppress the speed of psychomotor reactions.
Kurantil
The main active ingredient of the drug slows down the process of gluing platelets and improves blood circulation. When taken orally in large doses, "Curantil" 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 the treatment of "Kurantila" a person needs to refrain from drinking tea and coffee, since against this background the therapeutic effect of the drug may decrease.
This medication is not indicated for persons under the age of twelve due to lack of clinical experience with 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 causing dizziness in the patient.
Opinions
According to reviews, medical professionals prescribe antithrombotic agents in the event of thrombosis andthromboembolism. The drugs effectively cope with the task.
Doctors do not recommend self-medication, as such activities in most cases lead to severe hemorrhagic complications in patients.
There are a huge number of reviews of antithrombotic drugs from people who have undergone serious illnesses and operations, they highly appreciate the effect of such drugs, for example, Clopidogrel, Curantil, Ticlopidin. But their appointment and monitoring of admission should be carried out only by a doctor.
