Persantine


Also found in: Dictionary.

Persantine

 [per-san´tēn]
trademark for preparations of dipyridamole, a coronary vasodilator used to prevent clotting associated with mechanical heart valves and as an adjunct in radionuclide myocardial perfusion imaging.

dipyridamole

Apo-Dipyridamole FC (CA), Apo-Dipyridamole SC (CA), Persantin (UK), Persantine

Pharmacologic class: Platelet adhesion inhibitor

Therapeutic class: Antiplatelet agent, diagnostic agent (coronary vasodilator)

Pregnancy risk category B

Action

Unclear. May reduce platelet aggregation by inhibiting phosphodiesterase, adenosine uptake, or formation of thromboxane A2.

Availability

Tablets: 25 mg, 50 mg, 75 mg

Indications and dosages

To prevent thromboembolism in patients with prosthetic heart valves

Adults: 75 to 100 mg P.O. q.i.d.

Off-label uses

• Prevention of myocardial reinfarction (given with aspirin)

• Thrombotic thrombocytopenia purpura

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:

• hypotension, hepatic insufficiency, severe coronary artery disease

• pregnant or breastfeeding patients

• children younger than age 12 (safety not established).

Administration

• Know that drug is usually given with warfarin when used to prevent thromboembolism.

• Give with a full glass of water at least 1 hour before or 2 hours after meals. If gastric distress occurs, give with food.

Adverse reactions

CNS: dizziness, headache

CV: hypotension

GI: abdominal distress

Hepatic: hepatic failure

Skin: rash

Interactions

Drug-drug. Adenosine: increased adenosine plasma level and CV effects

Cholinesterase inhibitors: counteracts activity of cholinesterase inhibitors

Drug-diagnostic tests. Hepatic enzymes: increased levels

Drug-behaviors. Alcohol use: increased risk of hypotension

Patient monitoring

• Monitor for therapeutic efficacy, including improved exercise tolerance and decreased need for nitrates.

• Assess platelet and coagulation studies regularly.

• Monitor ECG and vital signs, especially blood pressure.

• Monitor hepatic function tests regularly.

Patient teaching

• Advise patient to take drug 1 hour before or 2 hours after meals for best absorption.

Instruct patient to immediately report unusual tiredness, chest pain or other cardiac symptoms, upper right abdominal pain, yellowing of skin or eyes, or dark urine.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

Persantine®

Cardiology A formulation of dipyridamole used as an alternative to exercise in thallium myocardial perfusion imaging for evaluating CAD in Pts who cannot exercise adequately. See Exercise stress test.
References in periodicals archive ?
Patients pharmacologically stressed by either adenosine or persantine (dipyridamole) were NPO for 4 hours prior to administration and discontinued persantine products for 24 hours.
In cases where the cardiologist indicated a preference and for patients with low heart rates (less than 60 beats per minute), persantine (dipyridamole) was used as a pharmacological inducer.
Treadmill (n = 219, 75%) Positive (ischemia or infarction) 133 (61%) Negative (normal) 86 (39%) Pharmacologically induced stress (n = 72, 31 adenosine, 41 persantine; 25%) Positive (ischemia or infarction) 48 (67%) Negative (normal) 24 (33%) A smaller percentage of women (51%) were stressed by treadmill testing, but again this did not seem to influence the overall normal rates.
Treadmill (n = 93, 51%) Positive (ischemia or infarction) 14 (15%) Negative (normal) 79 (85%) Pharmacologically induced stress (n = 91, 30 adenosine, 61 persantine; 49%) Positive (ischemia or infarction) 31 (34%) Negative (normal) 60 (66%) Because 66% of all patients were stressed by treadmill, the researchers investigated whether there was a cause and effect relationship with higher reported normal rates in perfusion and gated studies in women related to their ability to reach 85% of maximal heart rate on treadmill exercise.
The current pharmacologic alternatives include: adenosine, dipyridamole (persantine), and dobutamine.
While they are less frequent with persantine (47%), they tend to be more serious than those associated with adenosine.
Pharmacokinetics of oral dipyridamole (Persantine) and its effect on platelet adenosine uptake in man.
The American Heart Association recommends aspirin alone or aspirin combined with other anti-clotting drugs, such as extended-release dipyridamole (Persantine or Aggrenox) or Plavix, for treating people who have had a heart attack, stroke, mini-stroke or a TIA.
Consider Persantine (dipyridamole), which by the researchers' estimates, doctors prescribed 4,832,889 times for elderly patients in 1994.[1] The Harvard researchers point out that as a blood thinner, Persantine is no better than common aspirin; its only legitimate indication is with warfarin in the treatment of patients with artificial heart valves.
What they fail to mention is that Persantine, also a vasodilator, was originally prescribed as an alternative to nitroglycerin.
Once the indications for Persantine changed, sales plummeted; 7 years later, no form of dipyridamole remains on the top-200 list.
One could easily forget that prescribing Persantine in 1987 was perfectly appropriate, based on standards of the day.