25 antiplat

Question 1

aspirin mechanism

Answer 1

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

Question 2

aspirin indications

Answer 2

“primary:

• stable angina
• *secondary prevention**:
• acute MI
• unstable angina, prior MI
• CABG patency
• TIA/stroke risk reduciton

”

Question 3

dipyridamole

mechanism, use, adverse effects

Answer 3

phosphodiesterase inhibitor

inhibits cAMP phosphodiesterase, lowering TXA2 levels

not used much anymore….

AE: HA, GI, rash

Question 4

ADP receptor inhibitors

Answer 4

clopidogrel

prasugrel

ticagrelor

ticlopidine(not used much anymore)

Question 5

mechanism of ADP receptor inhibitors

Answer 5

block ADP binding to P2Y12 which allows for activaiton of GP IIb/IIIa

stops platelet aggregation

Question 6

clopidogrel indications

Answer 6

MI, stroke

reduced thrombus post-stent placement

Question 7

glycoprotein IIb/IIIa inhibitors

Answer 7

abciximab

tirofiban

eptifibatide

Question 8

adverse effects of glycoprotein IIb/IIIa inhibitors

Answer 8

bleeding

thrombocytopenia(rare)

Question 9

indications for glycoprotein IIb/IIIa inhibitors

Answer 9

patients with UA/NSTEMI undergoing PCI

Question 10

difference between

clopidogrel

prasugrel

ticagrelor

Answer 10

clopidogrel rquires 2 passes through p450 enzymes to become active(CYP2C19)

prasugrel requires just 1 pass

ticagrelor does not need any liver activation!