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臨床薬理
Vol. 40 (2009) No. 6 P 267-272

記事言語:

http://doi.org/10.3999/jscpt.40.267

特集/抗血小板薬をめぐる最近の話題

Low-dose aspirin (LDA) is the mainstay of prophylactic antiplatelet therapy for patients with cardiovascular and cerebrovascular diseases. LDA induces gastrointestinal mucosal injury directly and indirectly via reduced mucosal prostaglandin by inhibition of cyclooxygenase. Dual antiplatelet therapy, such as a combination of LDA and thienopyridine derivatives, is often used after implantation of a drug-eluting stent. However, dual antiplatelet therapy significantly increases the risk of gastrointestinal bleeding. Proton pump inhibitors (PPI) reduce the risk of gastroduodenal bleeding in patients receiving dual antiplatelet therapy but attenuate the antiplatelet effect of clopidogrel, the most commonly used thienopyridine derivative. The optimal prophylaxis strategy for gastrointestinal bleeding in patients receiving antiplatelet therapy remains to be determined.

Copyright © 2009 日本臨床薬理学会

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