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Chỉ định và Liều dùng
Intravenous
Myocardial imaging Adult: 0.142 mg/kg/min infused over 4 min (0.567 mg/kg total) as adjunct to thallium-201. Oral Prophylaxis of thromboembolism following cardiac valve replacement Adult: As conventional tab: 300-600 mg daily in 3-4 divided doses, given w/ an oral anticoagulant. Oral Secondary prophylaxis of ischaemic stroke, Secondary prophylaxis of transient ischaemic attack Adult: As modified-release cap: 200 mg bid.
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Cách dùng
Should be taken on an empty stomach. Take 1 hr before meals. May be taken w/ meals to reduce GI discomfort.
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Hướng dẫn pha thuốc
Intravenous: Dilute in at least 1:2 ratio w/ NaCl 0.9% or 0.45%, or dextrose 5% to make a total volume of approx 20-50 mL.
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Thận trọng
Patient w/ hypotension, severe coronary artery disease including unstable angina or recent MI, aortic stenosis, decompensated heart failure, coagulation disorder, migraine, myasthenia gravis. Pregnancy and lactation.
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Tác dụng không mong muốn
Nervous: Headache, dizziness, faintness, seizure.
CV: Hypotension, angina, tachycardia. GI: Nausea, diarrhoea, vomiting. Resp: Bronchospasm. Haematologic: Thrombocytopenia. Musculoskeletal: Myalgia. Dermatologic: Rash, urticaria, facial flushing, angioedema. Potentially Fatal: Cardiac death, MI, ventricular fibrillation, asystole, sinus node arrest, symptomatic ventricular tachycardia, stroke, transient cerebral ischemia (IV). |
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IV/Parenteral/PO: B
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Thông tin tư vấn bệnh nhân
This drug may cause dizziness, if affected, do not drive or operate machinery.
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Chỉ số theo dõi
Monitor BP, heart rate, ECG, LFT, respiration.
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Quá liều
Symptoms: Cardiac death, cardiac arrest, MI, chest pain, angina pectoris, ECG changes, syncope, cerebrovascular events, headache, myalgia, paraesthesia, warm feeling, flushes, sweating, restlessness, weakness, dizziness, hypotension, and tachycardia. Management: Symptomatic treatment. Perform gastric lavage. Administer xanthine derivatives (e.g. aminophylline 75-100 mg) to reverse haemodynamic effects.
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Tương tác
May increase plasma concentration and CV effects of adenosine. Enhances effects of oral anticoagulants and produces additive effects w/ other anti-platelets (e.g. aspirin). May increase hypotensive effect of BP lowering drugs. May counteract anticholinesterase effect and aggravate myasthenia gravis when used w/ cholinesterase inhibitors. May reduce the efficacy of fludarabine. Reduced absorption w/ antacids. Abolished coronary vasodilation w/ xanthine derivatives (e.g. theophylline, aminophylline, caffeine) during myocardial imaging.
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Tác dụng
Description:
Mechanism of Action: Dipyridamole, a platelet aggregation inhibitor, causes an accumulation of adenosine, adenine nucleotides, and cyclic AMP by inhibiting the activity of adenosine deaminase and phosphodiesterase, thus inhibiting platelet aggregation and producing vasodilation. Addtionally, it stimulates the release of prostacyclin or PGD2 and causes coronary vasodilation. Pharmacokinetics: Absorption: Incompletely absorbed from the GI tract. Time to peak plasma concentrations: Approx 75 min. Distribution: Widely distributed into body tissues. Crosses the placenta in small amounts and enters breast milk. Volume of distribution: 2-3 L/kg. Plasma protein binding: 91-99%, mainly to α1-acid glycoprotein. Metabolism: Metabolised in the liver to glucuronide conjugate; may undergo enterohepatic recirculation. Excretion: Via faeces (as glucuronide conjugates and unchanged drug). Terminal elimination half-life: 10-12 hr. |
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Đặc tính
 Source: National Center for Biotechnology Information. PubChem Database. Dipyridamole, CID=3108, https://pubchem.ncbi.nlm.nih.gov/compound/Dipyridamole (accessed on Jan. 21, 2020) |
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Bảo quản
Store between 15-25°C. Do not freeze. Protect from light.
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Phân loại MIMS
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Tài liệu tham khảo
Anon. Dipyridamole. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 07/11/2016. Buckingham R (ed). Dipyridamole. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/11/2016. Dipyridamole Injection, Solution (Hospira, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/11/2016. Dipyridamole Tablet, Film Coated (Teva Pharmaceuticals USA, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/11/2016. Joint Formulary Committee. Dipyridamole. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/11/2016. McEvoy GK, Snow EK, Miller J et al (eds). Dipyridamole. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 07/11/2016.
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Đăng xuất
