Phosphodiesterase Inhibitors

Cilostazol and Dipyridamole

Mechanism of action
These phosphodiesterase inhibitors prevent breakdown of cyclic
adenosine monophosphate (cAMP) within platelets, and
the resultant increase in intracellular cAMP levels leads to
diminished platelet activity. Dipyridamole may also inhibit
platelet aggregation via inhibiting adenosine uptake by red
blood cells (RBCs) or by inhibiting thromboxane A2 formation.
Clinical use
Dipyridamole may be used adjunctively with warfarin for preventing
postoperative thromboembolic complications associated
with prosthetic cardiac valves or in combination with
aspirin to prevent cerebrovascular ischemia. Cilostazol is used
to treat intermittent claudication (exercise-induced pain in
legs because of advanced peripheral vascular disease).
Adverse effects
Side effects are mainly limited to hypotension and accompanying
dizziness, abdominal distress, headache, and rash.