Should we know exactly about these two medications given after stent placement for heart disease? (Dual Antiplatelet Therapy)

Have you recently had a heart attack? Or have you had a stent placed in an artery in your heart? Your doctor may have prescribed you two types of medication. One might be aspirin. The other might be a pill with a different name. So you may be wondering, "Why am I being given two different medications for the same condition?" This is a question that many people have. Today, we're talking about DAPT, or Dual Antiplatelet Therapy, which is an important, life-saving treatment for many of you.

What is DAPT? Let's understand it simply.

To understand this, we first need to know a little about our blood. Our blood contains red blood cells, white blood cells, and other tiny pieces of cells. These are called platelets . The main job of these platelets is to stop bleeding when there is an injury somewhere in our body, and they rush to the site, stick together, and form a mesh to stop the bleeding. It's like quickly putting a plaster on a broken pipe. This is what we call blood clotting . This is a process that is really important for saving our lives. However, the problem starts where this blood clotting is not supposed to happen, that is, if it happens inside one of our blood vessels. Imagine what happens if a blood clot forms in a vein that carries blood to the heart? That blood vessel becomes blocked, stopping the flow of blood to the heart and causing a heart attack (Myocardial Infarction) . Also, if this blood clot goes to the brain, it can cause a stroke . So, Dual Antiplatelet Therapy (DAPT) is a treatment that stops those dangerous blood clots from forming inside the veins. In this, two types of drugs called "Antiplatelet" are given together. Antiplatelet is a drug that prevents platelets from sticking together, which means it prevents blood clots from forming. "Dual" means two. So, this is called Dual Antiplatelet Therapy because two types of drugs are given together.

Who needs this DAPT treatment?

Doctors don't give this treatment to everyone. It's only given to people who are at high risk of developing blood clots in their veins. This treatment is usually prescribed in the following cases:

What medications are given for DAPT?

We say that two types of drugs are given together in DAPT treatment. Those two types of drugs are: 1. Aspirin: This is a drug that many of you have heard of. Although it is usually used in high doses as a painkiller, it is given in very low doses to prevent blood clots in heart patients. 2. A drug in the P2Y12 Inhibitor group: This is the second drug. There are several types of drugs that belong to this group.

• Clopidogrel
• Prasugrel
• Ticagrelor

Your doctor will decide which of these three medications to give you and in what dosage.It depends on many factors, such as your medical condition, age, and whether you have other medical conditions.

What are the benefits and risks of DAPT treatment?

As with any treatment, DAPT treatment has benefits and some risks. It is important to be aware of both.

A little more about the risk of bleeding...

Don't be afraid when you hear "risk of bleeding." This can mean anything from minor things to serious things.

• Minor bleeding: Bleeding gums while brushing your teeth, nosebleeds, and turning blue quickly after a small injury are common.
• Serious bleeding: Although very rare, bleeding in the stomach or intestines (Gastrointestinal bleeding ) can occur. This can cause blood in the stool or make the stool black. Even more rarely, bleeding inside the brain can occur.

Side effects and interactions with other medications

Some people taking DAPT may experience minor side effects.

• Difficulty breathing
• Blood in the urine (Haematuria)
• Bruising
• Decreased platelet count in the blood ( Thrombocytopenia )
• Nasal polyps
• Nosebleed (Epistaxis)

Also, when taking DAPT, you should inform your doctor about other medications you are taking. Because some medications can interfere with the effectiveness of DAPT. Be especially careful with these medications.

• Other blood-thinning medications ( Anticoagulants ): If you are taking medications like Warfarin, the risk of bleeding is much higher.
• Painkillers (NSAIDs): Frequent use of medications like Ibuprofen and Diclofenac may increase the risk of stomach bleeding.
• Some medications for depression (Antidepressants).
• Medicines for gastritis (Proton Pump Inhibitors): Medicines like Omeprazole.

Therefore, don't forget to tell your doctor about everything you take, including pills, vitamins, and traditional medicines.

How long do I need to take this medicine?

This is also a problem for many people. The length of time to take DAPT is not the same for everyone. It varies from person to person.

• Some people can give it for a short period of time, like a month or two.
• Many people have to drink for a year or more.
• Even after stopping DAPT treatment, your doctor may tell you to take only aspirin for the rest of your life.

This time is determined by your doctor. There are several factors that affect it:

• What was the reason you were started on DAPT (a heart attack? Because a stent was placed?).
• Your age and overall health.
• How much risk of bleeding do you have?
• The risk of having another heart attack or stroke in the future.

What should you do to protect yourself when taking DAPT?

You also need to think about your safety while undergoing this treatment. Here are some simple things you can do to help.

• Take your medicine on time: Take your medicine exactly as your doctor tells you to, without skipping any days . If you miss a dose, it could cause a blood clot to form. Never stop taking your medicine without asking your doctor.
• Wear a medical ID card:If possible, always carry a bracelet or card that says you are taking DAPT. In the event of an emergency, this will help those treating you know that you are taking blood thinners.
• Tell all your doctors: Even if you are going to see a dentist or have any other surgery, you should tell them that you are taking DAPT, as some surgeries require you to temporarily stop taking this medication.

What are the symptoms that require immediate medical attention?

If you experience any of these symptoms, it could be a sign of serious bleeding. Therefore, do not delay and call your doctor immediately or go to the nearest hospital's Emergency Department (ETU). Also, if you suspect you have taken too much medication, call your doctor immediately. Otherwise,You can also call the National Poison Information Center at the Colombo National Hospital for advice. DAPT, Dual Antiplatelet Therapy, blood clotting, heart attack, stroke, stent, aspirin, clopidogrel, Clopidogrel, heart disease, blood thinners