Pharmacodynamics of antiplatelet agents used for correction of thrombotic complications in polytrauma
https://doi.org/10.25016/2541-7487-2015-0-1-96-102
Abstract
To optimize antithrombotic therapy in critical situations, specific and pleiotropic effects of different groups of antiplatelet agents were studied at various stages of fibrinogenesis. It was revealed that in the early stages of blood coagulation (initiation / amplification), expressed specific antiplatelet effects of cyclooxygenase (COX-1) and ADP-receptor inhibitors are associated with increased thrombin activity and the formation of chronometric hypercoagulation. Phosphodiesterase inhibitors have lower specific antiplatelet effects and influence the changes in thrombin activity to a lesser extent, thus facilitating chronometric and structural hypocoagulation in subsequent stages of fibrinogenesis. The differences in pleiotropic effects of antiplatelet agents under study necessitate their careful selection for antithrombotic therapy. Particularly, in cases of increased thrombin activity phosphodiesterase blockers are pathogenetically justified. Given the impact of drugs on all stages of fibrinogenesis in thrombotic and hemorrhagic syndrome, antiplatelet agents should be used based on an individual assessment of hemostasis. To quickly assess hemostatic potential, low-frequency piezoelectric thromboelastography is recommended.
About the Authors
A. G. Solovyev
Research Institute of Pharmacology and Regenerative Medicine named after E.D. Goldberg
Russian Federation
Russian Federation
PhD Med. Sci., resident doctor, Department of therapeutic drug monitoring, Research Institute of Pharmacology and Regenerative Medicine named after E.D. Goldberg (Russia, 634028, Tomsk, Lenina Str., 3)
V. V. Udut
Research Institute of Pharmacology and Regenerative Medicine named after E.D. Goldberg
Russian Federation
Russian Federation
Member, Russian Academy of Medical Sciences, Dr Med. Sci. Prof., chief laboratory of physiology, molecular and clinical pharmacology, Research Institute of Pharmacology and Regenerative Medicine name of E.D. Goldberg (Russia, 634028, Tomsk, Lenina Str., 3)
I. I. Tutrin
Siberian State Medical University
Russian Federation
Russian Federation
Dr Med. Sci., professor chair of anesthesiology and reanimatology faculty training and retraining of specialists, Siberian State Medical University (Russia, 634050, Tomsk, Moskovskiy tr., 2)
O. S. Karchagina
Research Institute of Pharmacology and Regenerative Medicine named after E.D. Goldberg
Russian Federation
Russian Federation
PhD Student laboratory of physiology, molecular and clinical pharmacology, Research Institute of Pharmacology and Regenerative Medicine name of E.D. Goldberg (Russia, 634028, Tomsk, Lenina Str., 3)
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Review
For citations:
Solovyev A.G., Udut V.V., Tutrin I.I., Karchagina O.S. Pharmacodynamics of antiplatelet agents used for correction of thrombotic complications in polytrauma. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2015;(1):96-102. (In Russ.) https://doi.org/10.25016/2541-7487-2015-0-1-96-102
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