MS24.pdf

10/19/23, 3:31 AM Realizeit for Student Medical Management Pharmacologic Therapy Cilostazol is approved by the U.S. Food and Drug Administration (FDA) for the treatment of claudication. Cilostazol, a phosphodiesterase III inhibitor, is a direct vasodilator that inhibits platelet aggregation. Studi...

10/19/23, 3:31 AM Realizeit for Student Medical Management Pharmacologic Therapy Cilostazol is approved by the U.S. Food and Drug Administration (FDA) for the treatment of claudication. Cilostazol, a phosphodiesterase III inhibitor, is a direct vasodilator that inhibits platelet aggregation. Studies have shown it plays a role in decreasing intimal hyperplasia after angioplasty and stenting. Furthermore, patients prescribed cilostazol report improvement in maximal walking distance and pain-free walking distance within 4 to 6 weeks (Farkas, Járai, & Kolossváry, 2017). This agent is contraindicated in patients with a history of heart failure. Antiplatelet agents, such as aspirin or clopidogrel, prevent the formation of thromboemboli which can lead to myocardial infarction and stroke and are recommended to treat patients with symptomatic PAD (Gerhard-Herman et al., 2016). Aspirin has been shown to reduce the risk of cardiovascular events (e.g., myocardial infarction, stroke, cardiovascular death) in patients with vascular disease; however, adverse events associated with aspirin use include gastrointestinal upset or bleeding (Gerhard-Herman et al., 2016). Use of dual antiplatelet agents, such as aspirin and clopidogrel, in patients with symptomatic PAD has not been well established. However, dual antiplatelet agents may be effective and may be reasonable to reduce limb-threatening events after revascularization. Statins improve endothelial function in patients with PAD. Studies suggest that statins reduce severity of intermittent claudication and increase walking distance to the onset of claudication (Gerhard-Herman et al., 2016). These medications have beneficial effects on vascular inflammation, plaque stabilization, endothelial dysfunction, and thrombosis, and have been linked to decreased rates of repeat peripheral interventions, amputations, and major adverse cardiovascular events up to 3 years post procedure (Saxon, Safley, & Mena-Hurtado, 2020). https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IagsrRDoag8O5uY%2buyG45kbB3bvIg9mMgs36U0K0gCcv… 1/1