Persantine
Persantine
[per-san´tēn]dipyridamole
Pharmacologic class: Platelet adhesion inhibitor
Therapeutic class: Antiplatelet agent, diagnostic agent (coronary vasodilator)
Pregnancy risk category B
Action
Unclear. May reduce platelet aggregation by inhibiting phosphodiesterase, adenosine uptake, or formation of thromboxane A2.
Availability
Tablets: 25 mg, 50 mg, 75 mg
Indications and dosages
➣ To prevent thromboembolism in patients with prosthetic heart valves
Adults: 75 to 100 mg P.O. q.i.d.
Off-label uses
• Prevention of myocardial reinfarction (given with aspirin)
• Thrombotic thrombocytopenia purpura
Contraindications
• Hypersensitivity to drug
Precautions
Use cautiously in:
• hypotension, hepatic insufficiency, severe coronary artery disease
• pregnant or breastfeeding patients
• children younger than age 12 (safety not established).
Administration
• Know that drug is usually given with warfarin when used to prevent thromboembolism.
• Give with a full glass of water at least 1 hour before or 2 hours after meals. If gastric distress occurs, give with food.
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Adverse reactions
CNS: dizziness, headache
CV: hypotension
GI: abdominal distress
Hepatic: hepatic failure
Skin: rash
Interactions
Drug-drug. Adenosine: increased adenosine plasma level and CV effects
Cholinesterase inhibitors: counteracts activity of cholinesterase inhibitors
Drug-diagnostic tests. Hepatic enzymes: increased levels
Drug-behaviors. Alcohol use: increased risk of hypotension
Patient monitoring
• Monitor for therapeutic efficacy, including improved exercise tolerance and decreased need for nitrates.
• Assess platelet and coagulation studies regularly.
• Monitor ECG and vital signs, especially blood pressure.
• Monitor hepatic function tests regularly.
Patient teaching
• Advise patient to take drug 1 hour before or 2 hours after meals for best absorption.
See Instruct patient to immediately report unusual tiredness, chest pain or other cardiac symptoms, upper right abdominal pain, yellowing of skin or eyes, or dark urine.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.