Anti-platelet drugs Flashcards
What are some examples of anti-platelet drugs?
Glycoprotein IIb/IIIa inhibitors
ADP receptor antagonists
What are some examples of glycoprotein (GP) IIb/IIIa drugs?
Eptifibatide
Abciximab
How is eptifibatide administered?
IV
For what is eptifibatide given?
ACS
PCI/stent
What is the GP IIb/IIIa drug abciximab?
A chimeric monoclonal antibody
*human/murine
What is a concern about abciximab and what is the result of this?
Numerous adverse effects
Little used
What is an example of an ADP antagonist?
Ticlopidine
What adverse effects caused the the black box warning for ticlopidine?
Neutropenia
Agranulocytosis
Thrombotic thrombocytopenia purpura
Aplastic anemia
What is ticlopidine reserved for?
Patients who are intolerant to aspirin or have failed aspirin therapy
What is a common ADP antagonist?(think Katy’s lectures)
Clopidogrel (plavix)
What is clopidogrel?
A prodrug converted to an unidentified active metabolite
What is the ultimate result of clopidogrel?
Preventing platelet aggregation
What affect does clopidogrel have on PPIs?
Decreased activity of PPI by CYP 2C19 inhibition
What affect do PPIs have on clopidogrel?
Increased risk of re-stenosis
What ADP antagonist is considered more effective than clopidogrel and ticlopidine?
Prasugrel
What is an advantage prasugrel has over clopidogrel?
Less inhibition by PPIs
What is a classic platelet antagonist?
Aspirin
What is the MOA of aspirin?
Inhibits platelet aggregation by acetylation of ADP receptor
How long does acetylation via aspirin last?
The life of the platelet
What are some adverse effects of aspirin?
GI bleed
Tinitis
What do we consider with adverse effects of aspirin and how can we avoid them?
Benefits vs. adverse effects
Minimal at low doses
What type of aspirin do you give for an acute MI?
Normal -> not baby aspirin
What kind of drug is dipyridamole?
Platelet antagoinst
What are the mechanisms of dipyridamole?
Platelet aggregation inhibitor
Vasodilator
Under what condition do you combine dipyridamole with another drug and what drug do you combine it with?
When pt has a mechanical heart valve
Warfarin
When is dipyridamole used as a diagnostic agent?
In CAD
Persasntine stress test