Browse the corpus

Cilostazol is a quinolone derivative primarily used to treat intermittent claudication due to peripheral vascular disease, the FDA-approved indication. Cilostazol is also indicated for secondary prevention in patients with a history of transient ischemic attacks or non-cardioembolic ischaemic stroke. Cilostazol improves walking distance by promoting vasodilation and antiplatelet activity with inhibition of phosphodiesterase III and subsequent increases in available cAMP. This activity reviews the indications, contraindications, and use of cilostazol and highlights the role of the interprofessional team in monitoring the adverse effects of the drug. Objectives: Identify the mechanisms of action of cilostazol. Describe the adverse effects of cilostazol. Review and select appropriate monitoring of cilostazol. Summarize how the interprofessional team can collaborate to optimize therapeutic results with cilostazol. Access free multiple choice questions on this topic.

The oral lethal dose of cilostazol is over 5 g/kg in rats and mice and more than 2 g/kg in dogs. There is a lack of data on acute overdosage with cilostazol in humans. The signs and symptoms of an acute cilostazol overdose can present as a severe headache, diarrhea, hypotension, tachycardia, and possibly cardiac arrhythmia. In an overdose, patients require careful observation and supportive treatment. Cilostazol is highly protein-bound and unlikely to be efficiently removed by hemodialysis or peritoneal dialysis. Emptying the stomach by gastric lavage may be appropriate if needed.[25]

Healthcare professionals who plan to prescribe cilostazol should be fully knowledgeable about the drug's indications and contraindications. Cilostazol's primary use is treating intermittent claudication, which typically correlates with early-stage peripheral artery disease.[26] Prescribing clinicians (MDs, DOs, NPs, PAs) should know that the drug is usually administered twice daily as a 100 mg oral dose shortly before or after meals. Consider possible adverse side effects when using cilostazol in patients with supraventricular arrhythmias or a history of heart disease. Additionally, exercise caution when co-administering cilostazol with any other pharmacologic agent that may reduce blood pressure, as this may result in an additive hypotension and subsequent reflex tachycardia; therefore, pharmacists should watch for these potential drug interactions and report them to the prescribing clinicians. Both pharmacists and nurses can counsel patients on optimal dosing and possible adverse reactions. Patients receiving cilostazol should be closely monitored for tachyarrhythmias, hypotension, and signs of blood dyscrasia, which is primarily the responsibility of nurses, and they should report these findings to the prescribing clinician. The interprofessional health care team should work collaboratively to ensure patients taking cilostazol obtain regular follow-ups. The specialty medical professionals should weigh in as needed to ensure optimal healthcare outcomes for these patients.