Sikka Pranav, Bindra V K
Department of Pharmacology, ITS-CDSR, Muradnagar, Ghaziabad, Uttar Pradesh, India.
Indian J Crit Care Med. 2010 Oct;14(4):188-95. doi: 10.4103/0972-5229.76083.
Thromboembolic disorders are one of the disorders for which we are still on the look out for a safe and efficient drug. Despite the widespread use of antithrombotic drugs for the prevention and treatment of arterial and venous thrombosis, thromboembolic diseases continue to be a major cause of death and disability worldwide. This shows our inefficiency in searching efficacious and safe antithrombotic drugs. We have reached the basic mechanism of thrombus formation and by interrupting various steps of this mechanism, we can prevent as well as treat thromboembolic disorders. In continuation of Aspirin, now, we are using Clopidogrel, Ticlopidine and GpIIb/IIIa inhibitors (Abciximab, Tirofiban and Eptifibatide). Warfarin is an old antithrombotic drug which is still being used; but due to various side effects and drug interactions, we are bound to use newer drugs. Newer antiplatelet drugs include Prasugrel, Ticagrelor and Cangrelor, whereas newer thrombin inhibitors are Ximelgatran and Dabigatran. Apixaban is also a newer entry in this category as factor Xa inhibitor. Idrabiotaparinux is an indirect inhibitor of Xa as it accelerates the activity of antithrombin. Moreover, researches and trials for better and safe drugs are ongoing.
血栓栓塞性疾病是我们仍在寻找安全有效药物的疾病之一。尽管抗血栓药物广泛用于预防和治疗动脉和静脉血栓形成，但血栓栓塞性疾病仍然是全球死亡和残疾的主要原因。这表明我们在寻找有效和安全的抗血栓药物方面效率低下。我们已经了解了血栓形成的基本机制，通过中断这一机制的各个步骤，我们可以预防和治疗血栓栓塞性疾病。继阿司匹林之后，我们现在使用氯吡格雷、噻氯匹定和糖蛋白IIb/IIIa抑制剂（阿昔单抗、替罗非班和依替巴肽）。华法林是一种仍在使用的老抗血栓药物；但由于各种副作用和药物相互作用，我们不得不使用更新的药物。更新的抗血小板药物包括普拉格雷、替格瑞洛和坎格雷洛，而更新的凝血酶抑制剂是希美加群和达比加群。阿哌沙班作为一种新型的Xa因子抑制剂也进入了这一类别。依达肝素是Xa的间接抑制剂，因为它能加速抗凝血酶的活性。此外，关于更好、更安全药物的研究和试验正在进行中。
