Anticoagulant drugs combination therapy

Careful monitoring and appropriate dosage adjustments usually will permit safe administration of combined therapy. Critical times during therapy occur when an interacting drug is added to or discontinued from a patient stabilized on anticoagulants. 

Aspirin is a direct-acting antiplatelet drug, (Its prolonged duration of action after therapy is discontinued will be discussed below under clinical use of the combination of anticoagulant and antiplatelet drugs,) A summary of its pharmacology is in Table I. 

There are a number of additional targets that may lead to effective antithrombotic therapy in ACS. In terms of anticoagulants, the concepts of agents that have dual inhibitor sites such as the one we find in heparin but that lack in some of its undesirable qualities could be very useful. The same concept may apply to drugs that have both anticoagulant and antiplatelet properties, It is quite probable that inhibitors of tissue factor as well as of the platelet ADP receptor when combined with aspirin might be very effective. An ability to block the feedback action of the polyphosphates released from platelets upon activation is also an attractive aim (Fig. 3),... 

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