Are you taking care of your stomach while taking medicine?

There are a large number of patients with cardiovascular and cerebrovascular diseases in my country, and antithrombotic drugs are also an important measure for the treatment and prevention of cardiovascular and cerebrovascular diseases. When taking these drugs, I would like to ask, "My friends, have you protected your stomach?"

What are antithrombotic drugs? Antithrombotic drugs include antiplatelet drugs and anticoagulants. Commonly used antiplatelet drugs include enteric-coated aspirin tablets, clopidogrel tablets, and ticagrelor tablets. Commonly used anticoagulant drugs include warfarin, rivaroxaban, and dabigatran.

The formation of blood clots is the main cause of acute myocardial infarction and cerebral infarction, and antithrombotic drugs have become the key to treating vascular diseases and a powerful tool in the hands of doctors.

But drugs are a double-edged sword. While we enjoy the benefits, we must also understand their harms. Antithrombotic drugs can cause varying degrees of digestive tract damage and symptoms, such as nausea, acid reflux, heartburn, upper abdominal discomfort, and even digestive bleeding.

Aspirin mainly inhibits prostaglandin synthesis or directly damages the gastrointestinal mucosa, causing ulcers and bleeding. Clopidogrel and ticagrelor tablets mainly inhibit platelet aggregation by inhibiting adenosine diphosphate, but at the same time, these drugs can also inhibit platelet growth factors, hinder angiogenesis, and hinder the repair of gastrointestinal mucosa. Warfarin mainly causes bleeding by inhibiting vitamin K-dependent coagulation factors. New anticoagulants (rivaroxaban, rivaroxaban, dabigatran) are mainly related to small intestinal mucosal permeability glycoproteins.

Having said so much, who needs to protect their stomach? There are three situations, as follows:

First, multiple drugs

1. Triple antithrombotic drugs (a random combination of three antithrombotic drugs)

2. Dual antiplatelet drugs (taking two antiplatelet drugs at the same time)

3. Dual antithrombotic drugs (one antiplatelet drug combined with one anticoagulant drug)

Second, antithrombotic drugs alone

Remember the "1 1/3" and "1 2/3" principles, that is, if you use antiplatelet drugs alone and have one or two of the following risk factors, you need to protect your stomach, as follows:

a.1/3, i.e. one of the three, had a history of ulcer, used steroid hormones, and used nonsteroidal anti-inflammatory drugs.

b.2/3 means two out of three: the elderly, gastroesophageal reflux, and gastrointestinal symptoms.

Third, anticoagulant drugs alone

If anticoagulants are used alone, remember the "1 2/3" principle, that is, if anticoagulants are used alone and the following two risk factors exist at the same time, gastric protection treatment is required, as follows:

2/3, or two of the three, had a history of ulcers, used steroid hormones, used nonsteroidal anti-inflammatory drugs, were elderly, had gastroesophageal reflux, and had gastrointestinal symptoms.

So how do you protect your stomach?

1. Use drugs that inhibit gastric acid: proton pump inhibitors (such as omeprazole, etc.), H2 receptor antagonists (such as famotidine, etc.).

2. Gastric mucosal protective drugs: Commonly used ones include teprenone, etc.

If you assess that you need to protect your stomach, please go to a regular hospital to put on a layer of armor for your gastrointestinal tube, so that you can still eat delicious food. Have you learned it?