Anticoagulants

Question 1

Anticoagulants of Coumarin Type

Answer 1

Coumarin-Derivate: Phenprocoumon, Warfarin

MOA: inhibition of the Vit K-dependent synthesis of clotting factors II, VII, IX, X (“Vit K antagonism“)
→ less blood clotting

but: when increased nutritional Vit K supply → anticoagulative effect is reduced! → still: no need to follow a Marcumar-Diät

because of this Food-Drug-Interaction:
- frequent & continous control of INR (International normalized ratio (INR) = derivative of prothrombin time)
→ evtl. dose adaption
- no abrupt/drastic changes of diet!

Question 2

Clopidogrel

Answer 2

• prodrug
• active compound: inhibition of P2Y12 receptor
  (crucial for platelet activation & fibrin cross-linkage)
• wird über CYP2C19 aktiv
  → Polymorphisms! (reduced efficacy in poor metabolizers)
  → Drug-Drug-Interactions (e.g. CYP2C29 gehemmt durch PPI) → reduced efficacy