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抗凝血劑
Dipyridamole
產品
•半衰期為10-12小時,一天能吃到四次
短效型:
作用
抗血小板:
•抑制PDE(phosphodiesterase),增加血小板間的cA
MP,降低血小板凝集形成血栓機率
用途
人工心臟瓣膜置換(prosthetic heart valves
):
• 換成人工心臟瓣膜後,為降低發生栓塞的風險,
術後需要使用抗凝血劑~通常是warfarin
• 在一些特別的情形,為了更多降低栓塞機率,會
再併用抗血小板劑~例如dipyridamole (75-100 m
g qid)
長輩要小心的
副作用
神經方面:
• 眩暈 (14%)
• 頭痛 (2%)
給長輩的建議
Beers Criteria:
• 65歲以上的長輩服用短效型dipyridamole時,是
有發生姿勢性低血壓的風險存在~比較敏感的可能
會跌倒
• 因為dipyridamole在預防血栓的角色是搭配別人
,並不是無可取代~所以能考慮用別的抗血小板劑
替代
• (Ref.) Dipyridamole (oral, short-acting formulation; does not apply to the extended-rel
ease combination with aspirin) is identified in the Beers Criteria as a potentially inappr
opriate medication to be avoided in patients 65 years and older (independent of diagn
osis or condition) due to its potential for causing orthostatic hypotension and availabili
ty of more effective alternatives. Of note, dipyridamole intravenous is acceptable for u
se in cardiac stress testing (Beers Criteria [AGS 2019]).
Pharmacy Quality Alliance (PQA):
• 短效型dipyridamole對65歲以上的長輩而言,算
是高風險藥物~可能跌倒
• (Ref.) Dipyridamole (oral, short-acting formulation; does not apply to the extended-rel
ease combination with aspirin) is identified as a high-risk medication in patients 65 ye
ars and older on the PQAs Use of High-Risk Medications in the Elderly (HRM) perfor
mance measure, a safety measure used by the Centers for Medicare and Medicaid S
ervices (CMS) for Medicare plans (PQA 2017).

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