Propacetamol augments inhibition of platelet function by diclofenac in volunteers
| Autor: | Per H. Rosenberg, E. Munsterhjelm, M.T. Syrjälä, Tomi T. Niemi, O. Ylikorkala |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Blood Platelets Male Diclofenac Platelet Aggregation Platelet Function Tests Analgesic 030204 cardiovascular system & hematology Pharmacology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Double-Blind Method 030202 anesthesiology medicine Humans Cyclooxygenase Inhibitors Platelet Propacetamol Acetaminophen Pain Measurement Cross-Over Studies biology business.industry Anti-Inflammatory Agents Non-Steroidal Membrane Proteins Drug Synergism Crossover study 3. Good health Isoenzymes Thromboxane B2 stomatognathic diseases Anesthesiology and Pain Medicine chemistry Prostaglandin-Endoperoxide Synthases Anesthesia Cyclooxygenase 1 biology.protein Cyclooxygenase business medicine.drug |
| Zdroj: | British Journal of Anaesthesia. 91:357-362 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aeg195 |
| Popis: | Background Acetaminophen (paracetamol) enhances the analgesic effect of non-steroidal anti-inflammatory drugs (NSAIDs). Acetaminophen is a weak inhibitor of cyclooxygenase (COX), and its combination with an NSAID may augment COX inhibition-related side effects. Methods Ten healthy male volunteers (21–30 yr) were given diclofenac 1.1 mg kg−1 alone, a combination of propacetamol 30 mg kg−1 (which is hydrolysed to 50% acetaminophen) and diclofenac 1.1 mg kg−1 or placebo intravenously in a double blind, crossover study. Platelet function was assessed at 5 min, 90 min and 22–24 h by photometric aggregometry, platelet function analyser (PFA-100™) and by measuring the release of thromboxane B2 (TxB2). Analgesia was assessed with the cold pressor test. Results Platelet aggregation induced with arachidonic acid was fully inhibited by both diclofenac alone and the combination at the end of the 30-min drug infusion. Propacetamol augmented the inhibition by diclofenac at 90 min (P=0.014). At 22–24 h, platelet function had fully recovered. TxB2 release was inhibited by the combination of propacetamol and diclofenac at 90 min in comparison with diclofenac alone (P=0.027). PFA-100™ detected no difference in platelet function between these two groups. No analgesic effect was detected with the cold pressor test. Conclusions The combination of propacetamol and diclofenac inhibits platelet function more than diclofenac alone. This should be considered when assessing the risk of surgical bleeding. |
| Databáze: | OpenAIRE |
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