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Thrombozytenaggregationshemmer: Was sind die Risiken?


Curkovic, Ivanka; Egbring, Marco; Kullak-Ublick, Gerd A (2013). Thrombozytenaggregationshemmer: Was sind die Risiken? Praxis, 102(20):1243-1250.

Abstract

The most common risks related to platelet inhibitor therapy are bleeding, drug-drug interactions and therapeutic failure. The new substances prasugrel and ticagrelor are more potent platelet inhibitiors than clopidogrel. This reduces the incidence of ischemic events, but also potentially increases the bleeding risk. Clopidogrel therapy has up to 20% non-response rates, which can partially be explained by genetic polymorphisms and drug-drug interactions. Currently no evidence exists that ticagrelor or prasugrel efficacy is affected by genetic polymorphisms. The therapy in patients at risk still has to be carefully adapted to minimize adverse events. Patients older than 75 years and/or weighing less than 60 kg should receive a reduced dose of prasugrel. The combination of ticagrelor with strong cytochrome-P450-3A4 inhibitors is contraindicated.

Abstract

The most common risks related to platelet inhibitor therapy are bleeding, drug-drug interactions and therapeutic failure. The new substances prasugrel and ticagrelor are more potent platelet inhibitiors than clopidogrel. This reduces the incidence of ischemic events, but also potentially increases the bleeding risk. Clopidogrel therapy has up to 20% non-response rates, which can partially be explained by genetic polymorphisms and drug-drug interactions. Currently no evidence exists that ticagrelor or prasugrel efficacy is affected by genetic polymorphisms. The therapy in patients at risk still has to be carefully adapted to minimize adverse events. Patients older than 75 years and/or weighing less than 60 kg should receive a reduced dose of prasugrel. The combination of ticagrelor with strong cytochrome-P450-3A4 inhibitors is contraindicated.

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Additional indexing

Other titles:Thrombocyte aggregation inhibitors: what are the risks?
Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Clinical Pharmacology and Toxicology
08 University Research Priority Programs > Integrative Human Physiology
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:General Medicine
Language:German
Date:2013
Deposited On:26 Feb 2014 12:39
Last Modified:18 Aug 2018 15:17
Publisher:Hans Huber
ISSN:1661-8157
OA Status:Closed
Publisher DOI:https://doi.org/10.1024/1661-8157/a001431
PubMed ID:24088235

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