25 antiplat Flashcards
aspirin mechanism
inactivates COX-1 via acetylation
prevents TXA2 production
- TXA2 is a vasocontstrictor/platelet aggregator
inactvation lasts for lifetime of platelet
starts working even before portal circulation
aspirin indications
“primary:
- stable angina
- *secondary prevention**:
- acute MI
- unstable angina, prior MI
- CABG patency
- TIA/stroke risk reduciton
”
dipyridamole
mechanism, use, adverse effects
phosphodiesterase inhibitor
inhibits cAMP phosphodiesterase, lowering TXA2 levels
not used much anymore….
AE: HA, GI, rash
ADP receptor inhibitors
clopidogrel
prasugrel
ticagrelor
ticlopidine(not used much anymore)
mechanism of ADP receptor inhibitors
block ADP binding to P2Y12 which allows for activaiton of GP IIb/IIIa
stops platelet aggregation
clopidogrel indications
MI, stroke
reduced thrombus post-stent placement
glycoprotein IIb/IIIa inhibitors
abciximab
tirofiban
eptifibatide
adverse effects of glycoprotein IIb/IIIa inhibitors
bleeding
thrombocytopenia(rare)
indications for glycoprotein IIb/IIIa inhibitors
patients with UA/NSTEMI undergoing PCI
difference between
clopidogrel
prasugrel
ticagrelor
clopidogrel rquires 2 passes through p450 enzymes to become active(CYP2C19)
prasugrel requires just 1 pass
ticagrelor does not need any liver activation!