Antiplatelet drugs

Question 1

What antiplatelets work by inhibition of platelet ADP (P2Y12) receptor? Which ones are irreversible and which one is reversible?

Answer 1

Clopidogrel and prasurgrel are irreversible

Ticagrelor is reversible binding

Question 2

What antiplatelet works by inhibition of phosphodiesterase in platelets? this inhibiton increases cAMP which increases PGI2 anti-aggregation effect

Answer 2

Dipyridamole

Question 3

What antiplatelets block platelet GIIb/IIIa receptor preventing fibrinogen binding and platelet aggregation?

Answer 3

1. Abciximab- monoclonal antibody
2. Eptifibatide- cyclic peptide
3. Tirofiban- non-peptide

Question 4

How often is Clopidogrel and prasurgrel taken?

Answer 4

once daily

Question 5

how often is ticagrelor taken?

Answer 5

PO BID

Question 6

1. how are Abciximab, Eptifibatide, Tirofiban administered?

Answer 6

parenteral

Question 7

How is aspirin metabolized?

Answer 7

hepatic

Question 8

how is clopidogrel eliminated?

Answer 8

well its activated by CYP2C19 then renal and fecal elimination

Question 9

How is Prasugrel eliminated?

Answer 9

Well its activated by CYP3A4/2B6 thats all we know

Question 10

How is Ticagrelor eliminated?

Answer 10

CYP3A4 metabolism to active metabolite

Question 11

how are Abciximab, Eptifibatide, Tirofiban eliminated and list them in order of least half life time to greatest.

Answer 11

1. renal elimination

2. A, E, T

Question 12

how is dipyridamole metabolized?

Answer 12

hepatic: Phase II conjugation

Question 13

Adverse effect of aspirin?

Answer 13

1. gastric upset

2. bleeding

Question 14

Adverse effect of clopidogrel, ticagrelor, prasurgel.

Answer 14

1. Bleeding ([P]-[T]>[C])
2. clopidogrel causes dyspepsia, gastritis and headache
3. ticagrelor causes dyspnea, bradyarrhythmias

Question 15

what adverse effect dose Abciximab, Eptifibatide, Tirofiban have

Answer 15

Bleeding

Question 16

Which antiplatelet might have its activation of prodrug blocked if taken with a PPI

Answer 16

Clopidogrel

Question 17

true or false: Prasugrel has a DDI with PPI

Answer 17

false

Question 18

use for aspirin?

Answer 18

1. Acute MI
2. unstable angina
3. ACS
4. PCI
5. secondary prevention of MI-Stroke

Question 19

uses of ticagrelor, clopidogrel, and prasugrel?

Answer 19

1. Acute MI-unstable angina

2. PCI

Question 20

which is best for secondary prevention of MI?

Answer 20

Dipyridamole

Question 21

which ones would you use for PCI and PCI only?

Answer 21

Abciximab, Eptifibatide, Tirofiban