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Cardiovascular Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
No information has been published on the use of dipyridamole, a selective coronary vasodilator, in pregnant women. Beta-blockers were discussed earlier, and are again discussed subsequently, under “Antihypertensives.”
Effects of Antithrombotic and Results of Drug Screening
Published in Josef Hladovec, Antithrombotic Drugs in Thrombosis Models, 2020
Dipyridamole, a pyrimido-pyrimidine derivative, was originally used since 1961 as a vasodilating agent with main indications in coronary diseases. It is this origin as a vasodilating agent that dipyridamole has in common with some other drugs exerting antithrombotic effects, such as pentoxifylline, suloctidil, ketanserin, calcium channel blockers, beta-adrenolytics, etc. Nevertheless, the favorable clinical effect of dipyridamole based on vasodilatation, e.g., in angina pectoris, has never been positively proven and the rationality of such indications remains questionable. Of course, other mechanismsm might contribute to some favorable effects. Already in the phase of testing as a vasodilating agent, it was supposed that the main mechanism of action might be accumulation of adenosine in the plasma due to the inhibition of its cellular uptake and metabolism (deamination) e.g., in erythrocytes and endothelial cells. In this way, the well known vasodilating effect of adenosine could be potentiated. First experimental studies suggesting the use of dipyridamole as an antithrombotic appeared in 196595 and the following years saw an explosion of interest in this use of the drug even before that of aspirin. Experimental and clinical studies amounted to several thousands, but in spite of that, and just as in the case of aspirin, it is still uncertain how the drug acts or whether its clinical use is fully justified.
Placement of Balloon-Expandable Intraluminal Stents in Iliac Arteries: First 171 Procedures
Published in Juan Carlos Jimenez, Samuel Eric Wilson, 50 Landmark Papers Every Vascular and Endovascular Surgeon Should Know, 2020
Juan Carlos Jimenez, Samuel Eric Wilson
Intervention or Treatment Received Patients were treated with a stainless steel stent (3.1 × 30 mm) which was crimp-mounted on an 8 × 30 mm angioplasty balloon catheter and delivered via a 10-French sheath, 30 cm in length. Conventional angioplasty was used as first-line therapy with those who did not respond adequately, then undergoing stent placement. Inadequate response was defined as a dissection, recoil leading to a residual stenosis of >30%, and/or a transtenotic mean pressure gradient of >5 mmHg. Additionally, stents were placed for restenotic lesions after prior angioplasty and total occlusions. Patients were pretreated with aspirin (325 mg daily) and dipyridamole (25 mg every 8 hours) starting 48 hours before the procedure and were continued on this regimen for 3 months after the intervention. Patients were systemically heparinized during the procedure.
Diagnosis of coronary artery disease: potential complications of imaging techniques
Published in Acta Cardiologica, 2022
Evangelos Sdogkos, Andrew Xanthopoulos, Grigorios Giamouzis, John Skoularigis, Filippos Triposkiadis, Ioannis Vogiatzis
Arrhythmias during diagnostic tests are usually due to the agents administered to detect stress-induced ischaemia. This can happen in both single-photon emission computed tomography (SPECT) and stress echocardiography. The occurrence of dangerous ventricular arrhythmias, although very unlikely, requires immediate treatment. Special care should also be taken when administering dipyridamole, or adenosine, to patients with atrioventricular conduction disorders since both may cause transient block at the atrioventricular node, and therefore the subsequent hemodynamic collapse of the patient. Nevertheless, dipyridamole is considered safer than dobutamine for major side effects (1/1000 vs. 1/300 exams) or deaths (1/10,000 vs. 1/5000), respectively. Finally, attention is required in patients with asthma or bronchospasm because the above stressors may exacerbate these diseases [8]. Regarding contrast echocardiography, ultrasound-enhancing agents’ use is extremely safe since they have not been proven to increase the rate of mortality or myocardial infarction. Minor adverse events include back pain, nausea, and headache and have a very low incidence. The incidence of severe allergic reactions and anaphylactoid reactions is considered negligible (0.01% and 0.006%, respectively). They are contraindicated only in case of a known or suspected hypersensitivity to their contents. [9]
Evaluation of the Presence and Functional Importance of Nucleoside Transporters in Lacrimal Gland for Tear Disposition of Intravenously Injected Substrate in Rabbits
Published in Current Eye Research, 2021
Hanuman Prasad Sharma, Nabanita Halder, Sundararajan Baskar Singh, T. Velpandian
Animals were divided into two groups; briefly, control and blocker pretreated. In blocker pretreated group, dipyridamole was administered intravenously (i.v.) at a dose of 5 mg/kg 30 min before the ribavirin (2.5 mg/kg; i.v.). Blood and tear samples were collected at 5, 15, 30, 60, 90, 120, 180, 240, 300 and 360 min after ribavirin administration (n = 4; each time point). Briefly, blood samples were collected in EDTA vials through the marginal ear vein. Plasma was separated immediately by centrifuging EDTAed blood at 3000 rpm for 5 min. Tear samples were collected using Schirmer’s strips (Madhu Instruments, India). Briefly, tear was collected till 5 mm mark by placing the strip in the lateral canthus of the rabbit eye. The strips with collected tear were then placed in preweighed microcentrifuge tubes and weighed. Finally, strips were cut at 10 mm mark and stored at −80°C for further analysis by LC-MS/MS.
Do patients with immune-mediated thrombotic thrombocytopenic purpura receiving caplacizumab need antithrombotic therapy?
Published in Expert Review of Clinical Pharmacology, 2021
Tuğrul Elverdi, Melis Dila Özer Çerme, Tahacan Aydın, Ahmet Emre Eşkazan
There was limited data on bleeding presented in the previous TTP studies, and minor bleeding episode rates were reported to be between 8%–80% (Table 1). These rates were higher especially if antiplatelets were used [15,16]. In the study of Quintini et al. [15], 80% of patients receiving standard therapy plus dipyridamole infusion had bleeding episodes, none of which were severe. In a randomized study, in which patients received either dual antiplatelet therapy (aspirin+dipyridamole) or placebo, treatment efficacy between two arms were comparable with minor and transient bleeding episodes in patients with antiplatelets [16] (Table 1). On the other hand, in a prospective randomized trial comparing PEX therapy with plasma infusion, all patients (n = 102) in both arms received aspirin and dipyridamole [17] (Table 1). Only eight patients had bleeding, one of which was fatal. In another case series, aspirin and dipyridamole combination demonstrated no significant benefit with serious bleeding complications [18] (Table 1). As TTP has been viewed more as a thrombotic disease, bleeding complications may mostly have been neglected in past studies.