# Understanding Antithrombotic Agents for Rehabilitation Therapy: A Comprehensive Narrative Review

**Authors:** Shuji Matsumoto, Rintaro Ohama, Takashi Hoei, Ryuji Tojo, Toshihiro Nakamura

PMC · DOI: 10.7759/cureus.58302 · Cureus · 2024-04-15

## TL;DR

This paper reviews antithrombotic drugs used in rehabilitation therapy, focusing on their types, mechanisms, and proper use for stroke prevention and treatment.

## Contribution

The paper provides a comprehensive overview of antithrombotic agents, emphasizing their classification and application in ischemic cerebrovascular disease.

## Key findings

- Antiplatelet agents like aspirin and clopidogrel have distinct mechanisms and indications.
- Anticoagulants such as heparin and DOACs require careful monitoring and dose adjustment.
- Appropriate selection of antithrombotic agents depends on the classification of cerebral infarction and risk of bleeding.

## Abstract

In rehabilitation medicine, attention must be paid to the medication. Among them, antithrombotic drugs are used for the initial treatment and secondary prevention of stroke, so as a basic knowledge, the pharmacological actions, characteristics, indications, and precautions for the use of antithrombotic drugs should be known. Antithrombotic agents are divided into antiplatelet agents and anticoagulants, and the appropriate antithrombotic agent is selected according to the main disease or condition. Antiplatelet agents include aspirin, clopidogrel, ticlopidine, prasugrel, ticagrelor, and cilostazol. Each antiplatelet agent has a different mechanism of action, characteristics, and indications, and should be prescribed with due consideration. Anticoagulants include heparin, synthetic Xa inhibitors, direct oral anticoagulants (DOACs), synthetic antithrombin agents, and warfarin. Knowledge of the mechanism of action, characteristics, and indications of each anticoagulant is necessary, as well as monitoring and dose adjustment. With regard to ischemic cerebrovascular disease (ICD) and antithrombotic agents, the first step is to classify cerebral infarction and to determine whether antiplatelet agents or anticoagulants should be used. Bleeding and recurrence prevention are important considerations in the selection of appropriate antithrombotic agents for the pathophysiology of ICD.

## Linked entities

- **Chemicals:** aspirin (PubChem CID 2244), clopidogrel (PubChem CID 2806), ticlopidine (PubChem CID 5472), prasugrel (PubChem CID 6918456), ticagrelor (PubChem CID 9871419), cilostazol (PubChem CID 2754), warfarin (PubChem CID 54678486)
- **Diseases:** stroke (MONDO:0005098), cerebral infarction (MONDO:0002679)

## Full-text entities

- **Diseases:** stroke (MESH:D020521), ICD (MESH:D002561), cerebral infarction (MESH:D002544), Bleeding (MESH:D006470)
- **Chemicals:** warfarin (MESH:D014859), ticlopidine (MESH:D013988), DOACs (-), prasugrel (MESH:D000068799), aspirin (MESH:D001241), heparin (MESH:D006493), cilostazol (MESH:D000077407), ticagrelor (MESH:D000077486), clopidogrel (MESH:D000077144)

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC11095057/full.md

## References

44 references — full list in the complete paper: https://tomesphere.com/paper/PMC11095057/full.md

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Source: https://tomesphere.com/paper/PMC11095057