Τίτλος:
P2Y12 Receptor Antagonists and Morphine: A Dangerous Liaison?
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
P2Y12 receptor antagonists, concurrently administered with aspirin in what has come to be commonly called dual antiplatelet therapy, are a mainstay of treatment for patients with acute coronary syndromes. Morphine, on the contrary, is a commonly used drug in the acute phase of acute coronary syndromes to relieve pain-with the added potential benefit of attenuating acutely raised sympathetic tone. In current guidelines, though, morphine is recommended with decreasing strength of recommendation. One reason is that it raises concern regarding the potentially significant interaction with antiplatelet agents, leading to impaired inhibition of platelet activation. In any case, it is still considered a mandatory part of the inventory of available medications in prehospital acute myocardial infarction management. The goal of the present review is to present published evidence on morphine and its potential interactions with P2Y12 receptor antagonists, as well as on the central issue of whether such interactions may underlie clinically significant effects on patient outcomes. © 2016 American Heart Association, Inc.
Συγγραφείς:
Giannopoulos, G.
Deftereos, S.
Kolokathis, F.
Xanthopoulou, I.
Lekakis, J.
Alexopoulos, D.
Περιοδικό:
Circulation: Cardiovascular Interventions
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
clopidogrel; morphine; prasugrel; purinergic P2Y receptor antagonist; purinergic P2Y12 receptor antagonist; ticagrelor; unclassified drug; antithrombocytic agent; morphine; narcotic analgesic agent; P2RY12 protein, human; purinergic P2Y receptor antagonist; purinergic P2Y12 receptor, acute coronary syndrome; Article; clinical outcome; dual antiplatelet therapy; human; maximum plasma concentration; platelet reactivity; practice guideline; priority journal; sympathetic tone; thrombocyte activation; treatment outcome; animal; blood; drug effects; drug interaction; drug resistance; metabolism; risk assessment; risk factor; signal transduction; thrombocyte, Analgesics, Opioid; Animals; Blood Platelets; Drug Interactions; Drug Resistance; Humans; Morphine; Platelet Aggregation Inhibitors; Purinergic P2Y Receptor Antagonists; Receptors, Purinergic P2Y12; Risk Assessment; Risk Factors; Signal Transduction; Treatment Outcome
DOI:
10.1161/CIRCINTERVENTIONS.116.004229
