Blood: Antiplatelets

Question 1

Three groups

Answer 1

Substances for platelet function

Question 2

First group - outside the platelets

Answer 2

Catechos
Collagen
Thrombin
Prostacyclin

Question 3

Second - wuthin the platelet

Answer 3

ADP
Prostaglandin D2 and E2
Serotonin

Question 4

Third group - generated within platelets and act within the platelet

Answer 4

Prostaglandin endoperoxidase
TXA2
CAMP
CGMP
Ca

Question 5

COX 1 inhibitor - Aspirin
Works through irreversible acetylation

Answer 5

Inhibit TXA2 for 7 to 10 days(the lifetime of the platelets)

Question 6

Inhibition of platelets with aspirin

Answer 6

Increases incidence of hemorrhagic shock

Question 7

Low aspirin

Answer 7

Inhibit COX 1 preferentially
But higher inhibits both 1 and 2

Question 8

Recommended aspirin

Answer 8

50 to 325mg

Question 9

Uses of aapirin

Answer 9

MI prevents recurrence and decreases mortality
Prophylaxis for cerebral ischeamia

Question 10

Other NSAIDS

Answer 10

Are reversible

Question 11

ADP inhibitors
P2Y12 receptor inhibitors

Answer 11

Clopidogrel and Prasugrel
TicaGRELor

Question 12

Mechanism of AFP inhibitors

Answer 12

Inhibit ADP binding to P2Y12 receptors so no expression of GP2a3b receptors
No platelet aggregation

Question 13

Ticlodipine not anymore

Answer 13

Neutropenia
Aplastic anemia
Thrombotic Thrombocytopinic Purpura

Question 14

Activated by CYTP450

Answer 14

Clopidogrel
Interactions exist with drugs that inavtivate them cytochrome like PPIs

Question 15

Take clopidogrel

Answer 15

Orally

Question 16

Take clopidogrel

Answer 16

Loading dose for effect after 3 - 5 days
Then reduce to maintenance

Question 17

Clopidogrel used in

Answer 17

Acute MI
Unstable angina
Stroke
Stent insertion

Question 18

Prasugrel

Answer 18

Greater side effects of bleeding than clopidogrel

Question 19

Ticagrelol

Answer 19

Maximum effect achieved after 1 - 3 hrs
But binds REVERSIBLY

Question 20

GP 2b3a receptor antagonists

Answer 20

Abciximab
Eptifibatide
Tirofiban

Question 21

Them eptifibatide work by

Answer 21

Blocking the GP receptors
IV

Question 22

Oral eptifibatide

Answer 22

Too toxic so IV

Question 23

Adjunct to heparin and aspirin

Answer 23

Eptifibatide In high risk angioplasty patients

Question 24

Adverse effect of all

Answer 24

Bleeding

Question 25

PDEI/Adenosine Uptake Inhibitors

Answer 25

Dypyramidole Cilostazol

Question 26

Inhibition of PDE

Answer 26

No degradation of CAMP that inhibits platelets aggregation

Question 27

Increased plasma adenosine

Answer 27

Activates adenosine receptors in platelets Stimulates CAMP which decreases aggregation Plus it VDs coronaries

Question 28

Dipyridamol

Answer 28

Potentiates prostacyclin decreasing adhesion to thrombogenic surfaces

Question 29

Taken with aspirin tk prevent cerebrovascular ischaemia (stroke)

Answer 29

Dipyridamole

Question 30

Treatment of intermittent claudication

Answer 30

Cilostazole - Oral

Question 32

Cilostazol contraindicated with HF as

Answer 32

It has VD activity so hypotension and reflex tachycardia

Question 33

Thrombin receptor antagonist

Answer 33

Voraxapar Atopaxar

Question 34

Vora and ato paxar

Answer 34

Oral Reversible Protease activated receptor antagonists

Question 35

Mechanism

Answer 35

Thrombin Receptor activated Peptide (TRAP) induced aggregation But dose dependent

Question 36

Used with aspirin and clopidogrel

Answer 36

Reduce risk of Heart attack and stroke in people who've had heart attack or with problems with blood flow in their legs