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首页> 外文期刊>The New England journal of medicine >Cyclooxygenase inhibitors and the antiplatelet effects of aspirin.
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Cyclooxygenase inhibitors and the antiplatelet effects of aspirin.

机译：环氧合酶抑制剂和阿司匹林的抗血小板作用。

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BACKGROUND: Patients with arthritis and vascular disease may receive both low-dose aspirin and other nonsteroidal antiinflammatory drugs. We therefore investigated potential interactions between aspirin and commonly prescribed arthritis therapies METHODS: We administered the following combinations of drugs for six days: aspirin (81 mg every morning) two hours before ibuprofen (400 mg every morning) and the same medications in the reverse order; aspirin two hours before acetaminophen (1000 mg every morning) and the same medications in the reverse order; aspirin two hours before the cyclooxygenase-2 inhibitor rofecoxib (25 mg every morning) and the same medications in the reverse order; enteric-coated aspirin two hours before ibuprofen (400 mg three times a day); and enteric-coated aspirin two hours before delayed-release diclofenac (75 mg twice daily) RESULTS: Serum thromboxane B(2) levels (an index of cyclooxygenase-1 activity in platelets) and platelet aggregation were maximally inhibited 24 hours after the administration of aspirin on day 6 in the subjects who took aspirin before a single daily dose of any other drug, as well as in those who took rofecoxib or acetaminophen before taking aspirin. In contrast, inhibition of serum thromboxane B(2) formation and platelet aggregation by aspirin was blocked when a single daily dose of ibuprofen was given before aspirin, as well as when multiple daily doses of ibuprofen were given. The concomitant administration of rofecoxib, acetaminophen, or diclofenac did not affect the pharmacodynamics of aspirin CONCLUSIONS: The concomitant administration of ibuprofen but not rofecoxib, acetaminophen, or diclofenac antagonizes the irreversible platelet inhibition induced by aspirin. Treatment with ibuprofen in patients with increased cardiovascular risk may limit the cardioprotective effects of aspirin.
机译：背景：患有关节炎和血管疾病的患者可能同时接受小剂量阿司匹林和其他非甾体类抗炎药。因此，我们研究了阿司匹林与通常的关节炎疗法之间的潜在相互作用方法：我们将以下药物组合给药六天：阿司匹林（每天81毫克）在布洛芬（每天400毫克）之前两个小时服用相同的药物，但顺序相反;对乙酰氨基酚前两个小时服用阿司匹林（每天1000毫克），相反顺序服用相同药物;阿司匹林在环氧合酶2抑制剂罗非昔布（每天25 mg）服用前2小时，以相反的顺序服用相同药物;布洛芬前两小时肠溶阿司匹林（每天3次400毫克）;结果：双氯芬酸缓释片（每天两次，每次75毫克）前两小时和肠溶阿司匹林结果：血栓烷B（2）水平（血小板中环氧合酶1活性的指标）和血小板凝集在给予24小时后被最大程度地抑制在每天服用任何其他药物前服用阿司匹林的受试者，以及在服用阿司匹林之前服用罗非昔布或对乙酰氨基酚的受试者，在第6天服用阿司匹林。相反，当在阿司匹林之前每天服用一次布洛芬，以及当每天服用多次布洛芬时，阿司匹林可抑制血清血栓烷B（2）的形成和血小板聚集。罗非考昔，对乙酰氨基酚或双氯芬酸的同时给药不会影响阿司匹林的药效。结论：布洛芬但对罗非考昔，对乙酰氨基酚或双氯芬酸的同时给药不会拮抗阿司匹林引起的不可逆的血小板抑制作用。在心血管风险增加的患者中使用布洛芬治疗可能会限制阿司匹林的心脏保护作用。

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