Antiplatlets

Question 1

Cyclooxygenase inhibitor

Answer 1

Aspirin. Inhibit Cox mediated production of TXA2 which decreases aggregation. Irreversible.

Question 2

Caution with Aspirin

Answer 2

Reye’s syndrome with <16 and 3rd trimester early ductus arteriosus closure

Question 3

Clopidogrel

Answer 3

PRODRUG.

ADP receptor antagonist. Inhibits binding of ADP to P2Y12 receptor= inhibit activation of GP2a/3b. Irreversible.

Question 4

Ticagrelor

Answer 4

ADP receptor antagonist. Reversible as binds to a different site than clopidogrel

Question 5

Indications for ADP receptor antagonist

Answer 5

NSTEMI, STEMI, Ischemic stroke, TIA

Question 6

Dipyridamole

Answer 6

Phosphodiesterase inhibitor- inhibits cellular reuptake of adenosine. So intracellular adenosine remains high which inhibits platelet aggregation. Also prevents cAMP degradation which inhibits expression of GP2b/3a

Question 7

S/E Dipyridamole

Answer 7

V and D, Dizziness, caution with adenosine

Question 8

S/E ADP receptor antagonists

Answer 8

Bleeding, GI upset, thrombocytopenia

Question 9

What drug do you need to stop 7 days pre op

Answer 9

Clopidogrel