Pharmacy World and Science

, Volume 15, Issue 6, pp 243–251 | Cite as

Platelet aggregation inhibitors in neurology

  • A. Keyser


This literature review reports on secondary prevention of ischaemic stroke. The aim of secondary prevention is to protect patients who belong to a risk group from the occurrence of brain infarction. Symptomatic patients with a demonstrated carotid artery stenosis of 70% and more will most probably benefit from carotid endarterectomy if performed by a skilled surgeon in the absence of contraindications. Oral anticoagulant drugs play a minor role in the medical prevention of brain infarction. Antiplatelet drugs, however, have been in use for almost two decades and (meta-)analysis of clinical trials points to acetylsalicylic acid as a drug with a modest but certain contribution of about 15% in the endpoint reduction, even at lower dosages. The addition of dipyridamole to classic acetylsalicylic acid dose appears to increase the endpoint reduction to 30%. Neither dipyridamole nor sulfinpyrazone as monotherapy have been demonstrated to be efficacious in the secondary prevention of ischaemic stroke. Ticlopidine seems a promising alternative for acetylsalicylic acid in those patients who suffer adverse effects from acetylsalicylic acid. Ticlopidine itself, however, has a number of sideeffects that limit its application. New clinical trials are under way in order to improve the efficacy of drug treatment in the secondary prevention of brain infarction.


Acetylsalicylic acid Adverse effects Cerebral infarction Cerebral ischaemia, transient Dipyridamole Dosage Primary prevention Secondary prevention Sulfinpyrazone Ticlopidine 


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Copyright information

© Royal Dutch Association for the Advancement of Pharmacy 1993

Authors and Affiliations

  • A. Keyser
    • 1
  1. 1.Institute of NeurologySt. Radboud University Hospital, Catholic University NijmegenHB NijmegenThe Netherlands

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