AntiPlatelet Flashcards
Platelet degranulation release what
ADP, 5HT, and more
Platelet secretion releases what?
TXA
which step if blocked stops coagulation
4th crosslinking
PAR-1 and TP Pathway
q -> PLC -> DAG + IP3, DAG to PKC, IP3 to CA | CA to [PLA2] to make AA from phospholipids, [COX1] take AA to make TXA to trigger TP ( makes q to make PLC) | betagamma from PAR-1 and TP make GP-2b/3a activation
P2y-12 pathway
ADP -> i inhbits adenylyl cyclase -> cAMP inhibits 1-4 | PDE inhibts cAMP [want cAMP]
COX -1 COX-2
1 stomach and TXA 2 PGI and blood vessels
Asprin
irreve and non select but more on cox-1, longest effect bc life of platelet and usually taken at breakfast to avoid DDI
NSAID
non select reversible, due to this no thera platelet blocking
Celecoxib
selective 2 but increased clotting risk, used to avoid Cox-1 stomach stuff
Clopidogrel
Thienopyridines (P2y12) - 2 step (CYP 2C19)
2hr onset
DDI WITH OMEP
Irreversible
Q24H
Prasugrel
Thienopyridines (P2y12) 1 step by (3A4, 2B6)
30 MIN ONSET
Irreversible
Q24H
Ticagrelor
reversible P2y12 inhibitor
BID
8hr HL
30 min onset
Cangrelor
reversible P2y12 inhibitor
IV
5min HL
2 min onset
Dipyridamole, Cilostazol
PDE inhibit
Cil - for claudiaction
Dip - for 2nd stroke
Vorapaxar
PAR-1 inhibitor Reversible
3-4 day HL