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Platelet dysfunction after intravenous ketorolac or propacetamol.
T T Niemi1, J T Backman, M T Syrjälä
1Department of Anaesthesiology, Helsinki University Central Hospital, Finland.
Acta Anaesthesiologica Scandinavica
|February 11, 2000
Summary
Propacetamol (a paracetamol prodrug) reversibly impairs platelet function and thromboxane B2 production in adults. Ketorolac, a non-steroidal anti-inflammatory drug, demonstrated more potent and prolonged inhibition of platelet aggregation and thromboxane B2 formation.
Area of Science:
- Pharmacology
- Hematology
Background:
- Paracetamol is a weak cyclo-oxygenase inhibitor.
- High-dose paracetamol has shown efficacy and safety in pediatric studies.
- The hemostatic effects of propacetamol in adults were previously unexamined.
Purpose of the Study:
- To investigate the impact of propacetamol on hemostasis in adult volunteers.
- To compare the effects of propacetamol with ketorolac on platelet function and coagulation.
Main Methods:
- A double-blind, randomized, crossover study involving ten adult volunteers.
- Administration of intravenous propacetamol (60 mg kg(-1)) or ketorolac (0.4 mg kg(-1)).
- Evaluation of platelet aggregation and thromboxane B2 (TxB2) levels at various time points; coagulation parameters were also assessed.
Main Results:
- Both propacetamol and ketorolac decreased maximal platelet aggregation and TxB2 concentration.
- Ketorolac exhibited a more pronounced and sustained inhibition of platelet aggregation compared to propacetamol.
- Coagulation parameters remained unaffected by either drug.
Conclusions:
- Propacetamol administration results in reversible platelet dysfunction, evidenced by reduced maximal platelet aggregation and TxB2 levels.
- Ketorolac demonstrates a stronger inhibitory effect on platelet aggregation and TxB2 formation than propacetamol, with effects persisting for 24 hours.