Avanços terapêuticos em cardiologia: parte 4. Antiplaquetários em cardiologia / Terapeutic advances in cardiology: Part 4. Antiplatelets in cardiology

Os autores fazem uma revisäo dos antiagregantes plaquetários disponíveis. Chamam a atençäo que a hirudina é inibidora da trombina, o verapamil é antagonista da adrenalina, o ridogrel e o ômega 3 bloqueiam os endoperóxidos bem como a sulfinpirazona, a aspirina, dipiridamol e ticlopidina. Existem antiagregantes com açäo do fator de ativaçäo plaquetária como a ginkgo-biloba e o diltiazem. Fazem uma revisäo das indicaçöes clínicas destas drogas à luz dos conhecimentos atuais

Clinical profile, therapeutic approach and outcome of gouty arthritis in northern India.

Thirty patients with gouty arthritis were studied over 3 years. The diagnosis was established with the help of polarised light microscopy. All the patients were males, with a median age of 45 years. They belonged to the middle or upper socio-economic class and were obese (mean body mass index 29.7). Chronic alcoholism, diabetes mellitus and hypertension were present in one patient each. No patient had symptomatic coronary artery disease. Although 6 patients had a history of renal colic, only one had gouty nephropathy with chronic renal failure. Six patients had a positive family history of gout. The disease involved mostly the joints of the lower extremity and podagra was observed in 70% of patients. Eight patients had tophi at various sites. There were 17 'over producers' and 13 'under excretors' of uric acid. The treatment consisted of patient education, symptomatic control with non steroidal anti-inflammatory drugs and/or colchicine and antihyperuricaemic therapy. The overproducers were treated with allopurinol while the under excretors were treated with [corrected] sulfinpyrazone. In general, there was a good response to therapy as indicated by lowering of serum uric acid and the number of painful episodes per year. The overall profile of the disease appears similar to that seen in the West.

Estado actual de la terapia antiplaquetaria / Current status of antiplatelet therapy

Se definen los mecanismos de acción y el efecto preventivo de las drogas anti-plaquetarias en padecimientos cardiovasculares y cerebrales, a partir de estudios bibliográficos. Se concluye que el dipiridamol y la sulfinpirazona no superan al ácido acetíl salicílico como antiagregante plaquetario y que este último continúa como droga de elección para este tipo de profilaxis. Se hace énfasis en estudios con ácido acetíl salicílico en bajas dosis como antiagregante plaquetario