CARDIO: DIPYRIDAMOLE

Question 1

DIPYRIDAMOLE: INDICATIONS

Answer 1

• CVDx - 1st line in TIA and second line for Ischaemic Stroke where clopidogrel is not tolerated or contraindicated. Should be given with aspirin, can also be used as a monotherapy
• To induce tachycardia during a myocardial perfusion scan

Question 2

DIPYRIDAMOLE: MOA

Answer 2

• Both antiplatelet and vasodilatory effects
• End effect = increase in intra-platelet cAMP that inhibits platelet aggregation, reducing the risk of arterial occlusion
• Dypyramidole also blocks cellular uptake of adenosine, prolonging its effect on blood vessels to produce vasodilatation

Question 3

DIPYRIDAMOLE: ADVERSE EFFECTS

Answer 3

• Vasodilatory effects, including headache, flushing, dizziness, and GI symptoms that normally improve with time
• Increased risk of bleeding
• Rarely issues with thrombocytopenia (platelet issues)

Question 4

DIPYRIDAMOLE: WARNINGS

Answer 4

• Ischaemic heart Dx patients, aortic stenosis and heart failure
• Can cause vasodilatation and tachycardia that can exarcerbate these conditions
• Reduced perfusion after dypyramidole indicates cardiac ischaemia

Question 5

DIPYRIDAMOLE: INTERACTIONS

Answer 5

• Inhibits cellular uptake of adenosine
• Prolongs effects on the heart increasing the risk of cardiac arrest (reduce dose in those with adenosine)
• Increased risk of bleeding when dipyramidole is combined with other antiplatelet agents (aspirin, clopidogrel,) and anti coagulants (heparin, warfarin)