"Risk of combining clopidogrel with proton pump inhibitors - significance and possible solutions"@en . "RIV/00216208:11120/10:00002680!RIV11-MSM-11120___" . "7"^^ . "Riziko kombinace klopidogrelu s inhibitory protonov\u00E9 pumpy - v\u00FDznam a mo\u017Enosti \u0159e\u0161en\u00ED"@cs . . . "[81E8165C5CF0]" . "Riziko kombinace klopidogrelu s inhibitory protonov\u00E9 pumpy - v\u00FDznam a mo\u017Enosti \u0159e\u0161en\u00ED" . "285497" . "Bultas, Jan" . . "\u010Cesk\u00E1 a slovensk\u00E1 gastroenterologie a hepatologie" . . "RIV/00216208:11120/10:00002680" . . . "Riziko kombinace klopidogrelu s inhibitory protonov\u00E9 pumpy - v\u00FDznam a mo\u017Enosti \u0159e\u0161en\u00ED"@cs . . "Risk of combining clopidogrel with proton pump inhibitors - significance and possible solutions"@en . "clopidogrel; proton pump inhibitors; drug interactions; CYP2C19"@en . . . "1"^^ . "Riziko kombinace klopidogrelu s inhibitory protonov\u00E9 pumpy - v\u00FDznam a mo\u017Enosti \u0159e\u0161en\u00ED" . . "Inhibitory protonov\u00E9 pumpy (IPP) i klopidogrel jsou velmi \u010Dasto u\u017E\u00EDvan\u00E1 l\u00E9\u010Diva, bohu\u017Eel jejich sou\u010Dasn\u00E9 pod\u00E1v\u00E1n\u00ED m\u016F\u017Ee v\u00E9st k selh\u00E1n\u00ED protidesti\u010Dkov\u00E9ho \u00FA\u010Dinku a k akutn\u00ED aterotrombotick\u00E9 p\u0159\u00EDhod\u011B. Podstatou t\u00E9to l\u00E9kov\u00E9 interakce je nedostate\u010Dn\u00E1 bioaktivace prol\u00E9\u010Diva - klopidogrelu - inhibic\u00ED kl\u00ED\u010Dov\u00E9ho isoenzymu CYP2C19 navozenou n\u011Bkter\u00FDmi IPP. Studie sleduj\u00EDc\u00ED desti\u010Dkov\u00E9 funkce, zejm\u00E9na agregabilitu, dokl\u00E1daj\u00ED v\u00FDrazn\u00E9 dlouhodob\u00E9 sn\u00ED\u017Een\u00ED \u00FA\u010Dinku klopidogrelu na inhibici aktivace i agregace trombocyt\u016F p\u0159i komedikaci s omeprazolem a lanzoprazolem, m\u00E9n\u011B ji\u017E p\u0159i pod\u00E1v\u00E1n\u00ED pantoprazolu \u010Di esomeprazolu. V oblasti laboratorn\u00EDho testov\u00E1n\u00ED prim\u00E1rn\u00ED hemost\u00E1zy a dopadu inhibice bioaktivace klopidogrelu IPP jsou v\u00FDsledky konzistentn\u00ED. Jinak je tomu v\u0161ak u studi\u00ED sleduj\u00EDc\u00EDch prognostick\u00E9 ukazatele. Zde v\u00FDsledky studi\u00ED observa\u010Dn\u00EDch, \u010Dasto analyzuj\u00EDc\u00ED velmi rizikovou populaci, dokl\u00E1daj\u00ED v\u00FDrazn\u00FD n\u00E1r\u016Fst koron\u00E1rn\u00EDch p\u0159\u00EDhod, metaanal\u00FDza t\u00E9m\u011B\u0159 60 tis\u00EDc nemocn\u00FDch dokl\u00E1d\u00E1 vzestup o v\u00EDce ne\u017E 50 %. Anal\u00FDzy randomizovan\u00FDch stud" . "11120" . . "64" . "Proton pump inhibitors (PPIs) and clopidogrel are very frequently used drugs; unfortunately, their concurrent administration may result in failure of the antiplatelet effect and in an acute atherothrombotic event. The basis of this drug interaction is an insufficient bioactivation of the prodrug - clopidogrel - by inhibition of the key isoenzyme CYP2C19 induced by certain PPIs. Studies monitoring platelet functions, in particular aggregability, demonstrate distinctive long-term reduction of the clopidogrel effect on the inhibition of both activation and aggregation of thrombocytes in co-medication with omeprazole and lanzoprazole; less if pantoprazole or esomeprazole are administered. Within the laboratory testing of primary haemostasis and the effect of inhibition of bioactivation of clopidogrel by PPIs, results are consistent. However, the situation is different in studies monitoring prognostic indicators. Here, the results of observation studies, often analyzing a high risk population, demonstrate"@en . "1213-323X" . "V" . . . "CZ - \u010Cesk\u00E1 republika" . . "1"^^ . . "Inhibitory protonov\u00E9 pumpy (IPP) i klopidogrel jsou velmi \u010Dasto u\u017E\u00EDvan\u00E1 l\u00E9\u010Diva, bohu\u017Eel jejich sou\u010Dasn\u00E9 pod\u00E1v\u00E1n\u00ED m\u016F\u017Ee v\u00E9st k selh\u00E1n\u00ED protidesti\u010Dkov\u00E9ho \u00FA\u010Dinku a k akutn\u00ED aterotrombotick\u00E9 p\u0159\u00EDhod\u011B. Podstatou t\u00E9to l\u00E9kov\u00E9 interakce je nedostate\u010Dn\u00E1 bioaktivace prol\u00E9\u010Diva - klopidogrelu - inhibic\u00ED kl\u00ED\u010Dov\u00E9ho isoenzymu CYP2C19 navozenou n\u011Bkter\u00FDmi IPP. Studie sleduj\u00EDc\u00ED desti\u010Dkov\u00E9 funkce, zejm\u00E9na agregabilitu, dokl\u00E1daj\u00ED v\u00FDrazn\u00E9 dlouhodob\u00E9 sn\u00ED\u017Een\u00ED \u00FA\u010Dinku klopidogrelu na inhibici aktivace i agregace trombocyt\u016F p\u0159i komedikaci s omeprazolem a lanzoprazolem, m\u00E9n\u011B ji\u017E p\u0159i pod\u00E1v\u00E1n\u00ED pantoprazolu \u010Di esomeprazolu. V oblasti laboratorn\u00EDho testov\u00E1n\u00ED prim\u00E1rn\u00ED hemost\u00E1zy a dopadu inhibice bioaktivace klopidogrelu IPP jsou v\u00FDsledky konzistentn\u00ED. Jinak je tomu v\u0161ak u studi\u00ED sleduj\u00EDc\u00EDch prognostick\u00E9 ukazatele. Zde v\u00FDsledky studi\u00ED observa\u010Dn\u00EDch, \u010Dasto analyzuj\u00EDc\u00ED velmi rizikovou populaci, dokl\u00E1daj\u00ED v\u00FDrazn\u00FD n\u00E1r\u016Fst koron\u00E1rn\u00EDch p\u0159\u00EDhod, metaanal\u00FDza t\u00E9m\u011B\u0159 60 tis\u00EDc nemocn\u00FDch dokl\u00E1d\u00E1 vzestup o v\u00EDce ne\u017E 50 %. Anal\u00FDzy randomizovan\u00FDch stud"@cs . "4" .