Drug‑drug interaction mechanisms and clinical challenges in antithrombotic therapy for acute ischemic stroke
10.19845/j.cnki.zfysjjbzz.2026.0036
- VernacularTitle:急性缺血性脑卒中抗栓治疗的药物相互作用机制与临床挑战
- Author:
Weimin KOU
1
;
Simiao WU
1
Author Information
1. Department of Neurology， West China Hospital， Sichuan University， Chengdu， 610041， China; Center of Cerebrovascular Diseases， West China Hospital， Sichuan University， Chengdu， 610041， China
- Publication Type:Journal Article
- Keywords:
Ischemic stroke;
Antithrombotic drug;
Drug‑drug interaction;
UpToDate
- From:
Journal of Apoplexy and Nervous Diseases
2026;43(3):204-213
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically summarize the pharmacological characteristics and clinical applications of antithrombotic medications in ischemic stroke， as well as their interactions with drugs used for common comorbidities， and to provide a reference for clinical medication. Methods Based on the UpToDate database and the integration with pharmacokinetic and pharmacodynamic mechanisms， this study systematically analyzed interactions between antithrombotic agents and between antithrombotics and drugs for comorbid conditions. Interactions were categorized and evaluated based on the level of evidence. Results The distinct pharmacological mechanisms of different antithrombotic drugs determine their patterns of drug-drug interactions. Combination antithrombotic therapy produces synergistic antithrombotic effects but increases the risk of hemorrhage. Extensive interactions exist when antithrombotics are co-administered with medications for cardiovascular diseases， metabolic disorders， neuropsychiatric conditions， and infectious diseases. These interactions primarily involve the cytochrome P450 enzyme system and P-glycoprotein pathways， which may compromise therapeutic efficacy or elevate the risk of bleeding and thrombosis. Conclusion Multiple drug interactions are present in antithrombotic therapy for ischemic stroke. In clinical practice， it is essential to consider the impact of pharmacokinetic and pharmacodynamic mechanisms. By integrating tools such as pharmacogenomics and therapeutic drug monitoring， individualized medication strategies should be implemented to achieve an optimal balance between antithrombotic efficacy and safety.
- Full text:202606091512468806急性缺血性脑卒中抗栓治疗的药物相互作用机制与临床挑战.pdf
