Arterial Thrombosis and anti-platelet drugs Flashcards
Describe an arterial thrombosis?
High pressure
Artherosclerosis
Platelet rich thrombus
What is the treatment for arterial thrombosis?
Aspirin and other anti-platelet drugs
Modify risk factors for artherosclerosis
What is artherosclorosis?
Not the same as an arterial thombosis
Damage to endothelium
Recruitment of foamy macrophages rich in cholesterol
Forms plaque rich in cholesterol
Describe stable artherosclerotic plaques
Hyalinised and calcified
Can cause stable angina (coronary artery) and intermittent claudication (leg artery)
Describe unstable artherosclerotic plaque
Plaques rupture, platelets are recruited and cause acute thrombosis
Sudden
Unstable angina/MI
Stroke
What are risk factors for arterial thrombosis?
Hypertension Smoking Diabetes Mellitus All 3 causes endothelium damage High cholesterol
What is Virchow’s triad?
Stasis
Vessel wall
Hypercoagulability
What is platelet adhesion?
Platelets bind to subendothelial collagen via glycoprotein 1b and von Willebrand Factor
What happens in platelet aggregation?
Platelet attach to each other via GPIIbIIIa and fibrinogen
Describe the action of aspirin?
Inhibits cyclo-oxygenase which is necessary to produce Thromboxane A2 (a platelt agonist released from granules on activation)
What are side effects of aspirin?
Bleeding
Blocks production of prostaglandins
GI ulceration
Bronchospasm
What do clopidogrel and prasugel do?
ADP receptor antagonsits
What does Dipyridamole do?
Phospodiesterase inhibitor - reduces production of cAMP which is a second messenger in platelet activation
What does abciximab do?
Inhibit aggregation
