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In rats with chronic alloxan-induced hyperglycemia, pramiracetam and phenylpiracetam (but not piracetam) had a strong antiaggregant effect that was mediated by various mechanisms of platelet aggregation modulation. The effect of pramiracetam is mainly realized via the inhibition of thromboxane A2 metabolism, while activity of phenylpiracetam is primarily associated with a normalizing effect on function of constitutive NO synthase in platelets and vascular endothelium.