更新于：2024-11-08
Aspirin/Dipyridamole
阿司匹林/双嘧达莫
更新于：2024-11-08
概要
基本信息
最高研发阶段批准上市 |
首次获批日期 中国 (1994-01-01), |
最高研发阶段(中国)批准上市 |
特殊审评- |
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结构
分子式C33H48N8O8 |
InChIKeyNOHUXXDTQJPXSB-UHFFFAOYSA-N |
CAS号87653-67-6 |
关联
28
项与 阿司匹林/双嘧达莫 相关的临床试验A Randomized Controlled Trial to Evaluate the Outcomes With Aggrenox in Patients With SARS-CoV-2 Infection
PercutaNEOus Coronary Intervention Followed by Monotherapy INstead of Dual Antiplatelet Therapy in the SETting of Acute Coronary Syndromes: The NEO-MINDSET Trial A Drug Reduction Study for Patients With Acute Coronary Syndrome in the Unified Health System in Brazil
Dipyridamole Assessment for Flare Reduction in SLE
100 项与 阿司匹林/双嘧达莫 相关的临床结果
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100 项与 阿司匹林/双嘧达莫 相关的转化医学
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100 项与 阿司匹林/双嘧达莫 相关的专利（医药）
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58
项与 阿司匹林/双嘧达莫 相关的文献（医药）2024-08-01Pain Physician
Updated Assessment of Practice Patterns of Perioperative Management of Antiplatelet and Anticoagulant Therapy in Interventional Pain Management.
Article
作者: Manchikanti, Laxmaiah ; Hirsch, Joshua A ; Soin, Amol ; Pampati, Vidyasagar ; Sanapati, Mahendra R
BACKGROUND:
The role of antiplatelet/anticoagulant therapy is well known for its primary and secondary prevention of sequela from cardiovascular disease by decreasing the incidence of acute cerebral, cardiovascular, peripheral vascular, and other thrombo-embolicevents. The overwhelming data show that the risk of thrombotic events is significantly higher than that of bleeding during surgery after antiplatelet drug discontinuation. It has been assumed that discontinuing antiplatelet therapy prior to performing interventional pain management techniques is a common practice, even though doing so may potentially increase the risk of acute cerebral and cardiovascular events. A survey of practice patterns was conducted in 2012, since then the risks associated with thromboembolic events and bleeding, has not been systematically evaluated.
OBJECTIVE:
To conduct an updated assessment of the perioperative antiplatelet and anticoagulant practice patterns of U.S. interventional pain management physicians and compare this with data collected in 2012 with 2021 data regarding practice patterns of continuing or discontinuing anticoagulant therapy. STUDY DESIGNn: Postal survey of interventional pain management physicians.
STUDY SETTING:
Interventional pain management practices in the United States.
METHODS:
The survey was conducted based on online responses of the members of the American Society of Interventional Pain Physicians (ASIPP) in 2021. The survey was designed similar to the 2012 survey to assess updated practice patterns.
RESULTS:
The questionnaire was sent out to 1,700 members in October 2021. Out of these, 185 members completed the survey, while 105 were returned due to invalid addresses. The results showed that 23% changed their practice patterns during the previous year. The results also showed that all physicians discontinued warfarin therapy with the majority of physicians accepting an INR of 1.5 as a safe level. Low dose aspirin (81 mg) was discontinued for 3 to 7 days for low-risk procedures by 8% of the physicians, 34% of the physicians for moderate or intermediate risk procedures, whereas they were discontinued by 76% of the physicians for high-risk procedures. High dose aspirin (325 mg) was discontinued at a higher rate. Antiplatelet agents, including dipyridamole, cilostazol, and Aggrenox (aspirin, extended-release dipyridamole) were discontinued from 3 to 5 days by 18%-23% of the physicians for low-risk procedures, approximately 60% of the physicians for moderate or intermediate-risk procedures, and over 90% of the physicians for high-risk procedures. Platelet aggregation inhibitors clopidogrel, prasugrel, ticlopidine, and ticagrelor were discontinued for 3 to 5 days by approximately 26% to 41% for low-risk procedures, almost 90% for moderate or intermediate-risk procedures, and over 97% for high-risk procedures. Thrombin inhibitor dabigatran was discontinued by 33% of the physicians for low-risk procedures, 92% for moderate or intermediate-risk procedures, and 99% for high-risk procedures. Anti-Xa agents, apixaban, rivaroxaban, and Edoxaban were discontinued in over 25% of the physicians for low-risk procedures, approximately 90% for moderate or intermediate-risk procedures, and 99% for high-risk procedures.
LIMITATIONS:
This study was limited by its being an online survey of the membership of one organization in one country, that there was only a 11.6% response rate, and the sample size is relatively small. Underreporting in surveys is common. Further, the incidence of thromboembolic events or epidural hematomas was not assessed.
CONCLUSION:
The results in the 2021 survey illustrate a continued pattern of discontinuing antiplatelet and anticoagulant therapy in the perioperative period. The majority of discontinuation patterns appear to fall within guidelines.
2019-01-11Pain physician3区 · 医学
Responsible, Safe, and Effective Use of
Antithrombotics and Anticoagulants in
Patients Undergoing Interventional Techniques:
American Society of Interventional Pain
Physicians (ASIPP) Guidelines
3区 · 医学
Review
作者: Amol Soin ; Cyrus Bakhit ; Ramarao Pasupuleti ; Sudhir Diwan ; Jay S. Grider ; Michael E. Harned ; Muhammad Anwar ; Kenneth D. Candido ; Ramsin M. Benyamin ; Matthew R. Eng ; Mahendra Sanapati ; Elyse M. Cornett ; Matthew B. Novitch ; Hari Prabhakar ; Nebojsa Nick Knezevic ; Imran N. Mungrue ; Mark R. Jones ; Erik M. Helander ; Richard E. Latchaw ; Joshua A. Hirsch ; Timothy R. Deer ; Alan D. Kaye ; Sheri L. Albers ; John R. Swicegood ; Ricardo Vallejo ; Douglas Beall ; Thomas T. Simopoulos ; Salahadin Abdi ; Laxmaiah Manchikanti ; Richard D. Urman ; Sairam Atluri
Background: Interventional pain management involves diagnosis and treatment of chronic
pain. This specialty utilizes minimally invasive procedures to target therapeutics to the central
nervous system and the spinal column. A subset of patients encountered in interventional pain are
medicated using anticoagulant or antithrombotic drugs to mitigate thrombosis risk. Since these
drugs target the clotting system, bleeding risk is a consideration accompanying interventional
procedures. Importantly, discontinuation of anticoagulant or antithrombotic drugs exposes
underlying thrombosis risk, which can lead to significant morbidity and mortality especially in those
with coronary artery or cerebrovascular disease. This review summarizes the literature and provides
guidelines based on best evidence for patients receiving anti-clotting therapy during interventional
pain procedures.
Study Design: Best evidence synthesis.
Objective: To provide a current and concise appraisal of the literature regarding an assessment
of the bleeding risk during interventional techniques for patients taking anticoagulant and/or
antithrombotic medications.
Methods: A review of the available literature published on bleeding risk during interventional pain
procedures, practice patterns and perioperative management of anticoagulant and antithrombotic
therapy was conducted. Data sources included relevant literature identified through searches of
EMBASE and PubMed from 1966 through August 2018 and manual searches of the bibliographies
of known primary and review articles.
Results:
1. There is good evidence for risk stratification by categorizing multiple interventional
techniques into low-risk, moderate-risk, and high-risk. Also, their risk should be upgraded based on other risk factors.
2. There is good evidence for the risk of thromboembolic events in patients who interrupt antithrombotic therapy.
3. There is good evidence supporting discontinuation of low dose aspirin for high risk
and moderate risk procedures for at least 3 days, and there is moderate evidence that
these may be continued for low risk or some intermediate risk procedures.4. There is good evidence that discontinuation of anticoagulant therapy with warfarin, heparin, dabigatran
(Pradaxa®), argatroban (Acova®), bivalirudin (Angiomax®), lepirudin (Refludan®), desirudin (Iprivask®), hirudin,
apixaban (Eliquis®), rivaroxaban (Xarelto®), edoxaban (Savaysa®, Lixiana®), Betrixaban(Bevyxxa®), fondaparinux
(Arixtra®) prior to interventional techniques with individual consideration of pharmacokinetics and pharmacodynamics of the drugs and individual risk factors increases safety.
5. There is good evidence that diagnosis of epidural hematoma is based on severe pain at the site of the injection,
rapid neurological deterioration, and MRI with surgical decompression with progressive neurological dysfunction
to avoid neurological sequelae.
6. There is good evidence that if thromboembolic risk is high, low molecular weight heparin bridge therapy can be
instituted during cessation of the anticoagulant, and the low molecular weight heparin can be discontinued 24
hours before the pain procedure.
7. There is fair evidence that the risk of thromboembolic events is higher than that of epidural hematoma formation with the interruption of antiplatelet therapy preceding interventional techniques, though both risks are
significant.
8. There is fair evidence that multiple variables including anatomic pathology with spinal stenosis and ankylosing
spondylitis; high risk procedures and moderate risk procedures combined with anatomic risk factors; bleeding
observed during the procedure, and multiple attempts during the procedures increase the risk for bleeding complications and epidural hematoma.
9. There is fair evidence that discontinuation of phosphodiesterase inhibitors is optional (dipyridamole [Persantine],
cilostazol [Pletal]. However, there is also fair evidence to discontinue Aggrenox [dipyridamole plus aspirin]) 3 days
prior to undergoing interventional techniques of moderate and high risk.
10. There is fair evidence to make shared decision making between the patient and the treating physicians with the
treating physician and to consider all the appropriate risks associated with continuation or discontinuation of
antithrombotic or anticoagulant therapy.
11. There is fair evidence that if thromboembolic risk is high antithrombotic therapy may be resumed 12 hours after
the interventional procedure is performed.
12. There is limited evidence that discontinuation of antiplatelet therapy (clopidogrel [Plavix®], ticlopidine [Ticlid®], Ticagrelor [Brilinta®] and prasugrel [Effient®]) avoids complications of significant bleeding and epidural
hematomas.
13. There is very limited evidence supporting the continuation or discontinuation of most NSAIDs, excluding aspirin,
for 1 to 2 days and some 4 to 10 days, since these are utilized for pain management without cardiac or cerebral
protective effect.
Limitations: The continued paucity of the literature with discordant recommendations.
Conclusion: Based on the survey of current literature, and published clinical guidelines, recommendations for patients presenting
with ongoing antithrombotic therapy prior to interventional techniques are variable, and are based on comprehensive analysis of
each patient and the risk-benefit analysis of intervention.
Key words: Perioperative bleeding, bleeding risk, practice patterns, anticoagulant therapy, antithrombotic therapy, interventional
techniques, safety precautions, pain
2019-01-01Journal of thrombosis and haemostasis : JTH2区 · 医学
Preventing arteriovenous shunt failure in hemodialysis patients: a population‐based cohort study
2区 · 医学
Article
作者: Wu, H H ; Yang, C W ; Chang, T-Y ; Liu, S H ; Kuo, C F ; Lee, C C ; Tian, Y C ; Weng, C H ; Hsieh, M Y ; Fan, P Y ; Tu, K H ; Li, I-J
Essentials Uncertainty remains about antiplatelets for vascular access patency in hemodialysis patients. 95 971 people under hemodialysis were followed in a claims database in Taiwan. Aspirin reduced vascular access failure rate and did not increase major bleeding rate. Clopidogrel, Aggrenox, and warfarin might increase major bleeding rate. SUMMARY: Background Dialysis adequacy is a major determinant of survival for patients with end-stage renal disease. Good vascular access is essential to achieve adequate dialysis. Objectives This study evaluated the impacts of different drugs on the vascular access failure rate of an arteriovenous fistula or an arteriovenous graft and the rate of major bleeding in hemodialysis patients. Patients and methods We studied patients with end-stage renal disease registered in the Taiwan National Health Insurance program from 1 January 1997 to 31 December 2012. A total of 95 971 patients were enrolled in our study. Vascular access dysfunction was defined as the need for thrombectomy or percutaneous angioplasty. Major bleeding was defined as emergency department visits or hospitalization with a primary diagnosis of gastrointestinal bleeding or intracerebral hemorrhage. The adjusted odds ratios between person-quarters with or without antiplatelet or oral anticoagulant use were calculated using a generalized estimating equation. Results The odds ratio of vascular access failure was 0.21 (0.11-0.39) for aspirin, 0.76 (0.74-0.79) for clopidogrel, 0.67 (0.59-0.77) for dipyridamole, 0.67 (0.53-0.86) for Aggrenox and 0.96 (0.90-1.03) for warfarin. The highest odds ratio for intracerebral hemorrhage was 5.33 (1.25-22.72) in younger patients using Aggrenox. The highest odds ratio for gastrointestinal bleeding was 1.34 (1.10-1.64) for clopidogrel. Conclusion Antiplatelet agents, but not warfarin, might reduce the vascular access thrombosis rate. The gastrointestinal bleeding rate was increased in the group using clopidogrel. Aggrenox should be used with caution in young individuals because it might increase the rate of intracerebral hemorrhage.
3
项与 阿司匹林/双嘧达莫 相关的新闻（医药）
2022-04-26
100 项与 阿司匹林/双嘧达莫 相关的药物交易
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研发状态
批准上市
10 条最早获批的记录, 后查看更多信息
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| 适应症 | 国家/地区 | 公司 | 日期 |
|---|---|---|---|
| 脑卒中 | 加拿大 | 2000-04-17 | |
| 短暂性脑缺血发作 | 美国 | 1999-11-22 | |
| 缺血性卒中 | 美国 | 1999-11-22 | |
| 脑梗塞 | 中国 | 1994-01-01 |
未上市
10 条进展最快的记录, 后查看更多信息
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| 适应症 | 最高研发状态 | 国家/地区 | 公司 | 日期 |
|---|---|---|---|---|
| 新冠肺炎后遗症 | 临床3期 | 美国 | 2020-10-21 | |
| 头痛 | 临床3期 | 中国台湾 | 2002-09-01 |
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临床结果
临床结果
适应症
分期
评价
查看全部结果
N/A | 18 | (Extended Release Dipyridamole/Aspirin) | 顧鹽壓艱蓋憲衊襯顧齋(積簾製遞製選製簾鏇窪) = 廠齋網齋憲觸簾齋淵鏇 製觸構衊製廠淵遞鬱範 (壓願艱齋遞齋淵繭糧廠, 鬱衊鹹窪艱遞憲壓壓積 ~ 窪簾顧糧鹽糧鹹鬱餘構) 更多 | - | 2020-11-25 | ||
(Aspirin) | 顧鹽壓艱蓋憲衊襯顧齋(積簾製遞製選製簾鏇窪) = 積顧鬱獵襯觸鏇願遞網 製觸構衊製廠淵遞鬱範 (壓願艱齋遞齋淵繭糧廠, 衊鑰願製繭襯齋廠網鑰 ~ 積遞顧壓鏇顧鏇夢餘鑰) 更多 | ||||||
N/A | - | 鹹鑰鹽壓憲齋選構憲鹽(鏇製夢衊蓋衊壓襯繭艱) = 鬱積範獵膚鬱簾齋構艱 廠構艱憲鏇網積夢製築 (鹹鹹膚鑰鹽遞蓋繭網觸, 0.10 ~ 0.28) 更多 | 积极 | 2018-10-23 | |||
鹹鑰鹽壓憲齋選構憲鹽(鏇製夢衊蓋衊壓襯繭艱) = 網憲範鏇構壓蓋繭積壓 廠構艱憲鏇網積夢製築 (鹹鹹膚鑰鹽遞蓋繭網觸, 0.67 ~ 0.71) 更多 | |||||||
N/A | 664 | (Device Closure) | 蓋鬱構選鬱衊顧醖醖鹽(窪鬱遞鹽醖遞顧鹹顧壓) = 憲膚觸淵廠襯廠製願衊 夢淵簾糧顧簾膚窪築衊 (齋壓蓋繭壓廠築廠顧鬱, 鹹鏇築夢鹽鑰構製繭衊 ~ 夢憲淵構獵範衊顧願艱) 更多 | - | 2018-08-09 | ||
(Medical Management) | 蓋鬱構選鬱衊顧醖醖鹽(窪鬱遞鹽醖遞顧鹹顧壓) = 築襯獵網糧獵積鑰鏇繭 夢淵簾糧顧簾膚窪築衊 (齋壓蓋繭壓廠築廠顧鬱, 齋築顧衊襯選網糧鬱簾 ~ 壓蓋獵繭糧廠夢膚構網) 更多 | ||||||
N/A | 25 | (Dipyridamole 200mg and Aspirin 25mg Bid) | 築範膚醖鬱鏇餘壓顧願(憲網憲積齋構醖壓簾範) = 簾範鹹夢鏇選淵膚壓範 築遞鏇淵構壓壓衊遞遞 (齋範築觸廠窪獵蓋築鏇, 廠網窪襯窪願淵鹽蓋獵 ~ 獵齋窪鏇鏇衊積願繭窪) 更多 | - | 2017-09-05 | ||
(Dipyridamole 200 mg Bid) | 築範膚醖鬱鏇餘壓顧願(憲網憲積齋構醖壓簾範) = 憲廠蓋餘膚簾網觸淵築 築遞鏇淵構壓壓衊遞遞 (齋範築觸廠窪獵蓋築鏇, 簾淵窪淵膚衊繭構淵夢 ~ 築糧鹽積壓顧襯衊鑰醖) 更多 | ||||||
临床3期 | 1,295 | (Aggrenox Capsule) | 積齋網鏇繭構齋獵憲構(鏇願鑰顧廠醖艱糧蓋蓋) = 鬱鏇遞齋膚觸繭獵製獵 鏇餘繭顧願淵艱願選構 (築繭築範餘窪壓壓廠構, 餘憲餘選願繭艱構窪構 ~ 醖獵齋窪鑰憲窪鹹簾獵) 更多 | - | 2010-03-11 | ||
Acetylsalicylic Acid (ASA) (Acetylsalicylic Acid (ASA) 81 mg Tablet) | 積齋網鏇繭構齋獵憲構(鏇願鑰顧廠醖艱糧蓋蓋) = 艱蓋廠選構構觸膚鹹憲 鏇餘繭顧願淵艱願選構 (築繭築範餘窪壓壓廠構, 衊觸憲醖窪網願醖餘築 ~ 醖鹽範築壓遞蓋簾顧簾) 更多 | ||||||
临床4期 | 20,332 | Dipyridamole+Aspirin (Aspirin + Extended Release Dipyridamole) | 顧鑰齋遞襯鑰簾製糧觸(鏇鹹憲觸膚遞襯糧鬱廠) = 構簾鑰選獵網壓鹹選顧 蓋淵憲膚鬱鑰觸蓋憲廠 (鹽餘糧襯蓋窪廠網鹽夢, 餘糧醖憲願積顧遞網蓋 ~ 夢齋齋壓選鹽繭鏇艱淵) 更多 | - | 2009-09-02 | ||
Clopidogrel (Clopidogrel) | 顧鑰齋遞襯鑰簾製糧觸(鏇鹹憲觸膚遞襯糧鬱廠) = 觸顧製廠壓鹹蓋選鹹餘 蓋淵憲膚鬱鑰觸蓋憲廠 (鹽餘糧襯蓋窪廠網鹽夢, 鑰襯顧願蓋醖鏇遞衊糧 ~ 醖築窪獵壓鏇艱襯願襯) 更多 |
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