Dipyridamole Sample Clauses

Dipyridamole. Dipyridamole is a drug that alters platelet function via two main mechanisms. Firstly, it blocks the reuptake of adenosine into platelets, endothelial cells and erythrocytes, leading to increased extracellular concentrations of adenosine 144. This stimulates adenylyl cyclase activity, thus increasing cAMP levels. The rise in cAMP results in enhanced phosphorylation of vasodilator- stimulated phosphoprotein and subsequent reduced GP IIb/IIIa receptor activity and platelet aggregation 145. Secondly, dipyridamole inhibits the platelet cAMP-phosphodiesterases that inactivate cAMP, further augmenting the reduction in platelet aggregation 144. Until relatively recently, dipyridamole, used in combination with aspirin, formed the mainstay of secondary prevention of ischaemic stroke. Data from the ‘Prevention Regimen For Effectively avoiding Second Stroke’ (PRoFESS) study published in 2008 found that there were no significant differences in outcome in treating patients with either aspirin plus extended-release dipyridamole or clopidogrel, although there were more bleeding events with the dipyridamole regime (4.1 % vs 3.36 %; hazard ratio 1.15) 146, and thus the general preference for monotherapy over combination therapy has led to a change in guidelines, favouring clopidogrel 147. Dipyridamole continues to be used in the secondary prevention of ischaemic stroke in patients who do not tolerate ADP-receptor inhibitors, and is frequently prescribed alongside the coumarin anticoagulant, warfarin, in the prevention of postoperative thromboembolic events in patients with mechanical heart valve replacements 148 149.
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Related to Dipyridamole

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