Konorev ACS Drugs Flashcards
What are the ADP receptor blockers? (antiplatelet drug)
- Clopidogrel
Prasugrel
Ticagrelor
What are the platelet glycoprotein receptor blockers? ( Antiplatelet drug)
- Abciximab
- Eptifibatide
- Tirofiban
What are the tissue type plasminogen activator drugs? (thrombolytic drug)
- Alteplase
- Reteplase
- Tenecteplase
What are the streptokinase preparation drugs? (thrombolytic drug)
- Streptokinase
What type of thrombus forms in high pressure arteries as a result of platelets binding to the damaged endothelium and aggregation with little involvement of fibrin?
White thrombus
What type of thrombus forms in low pressure veins and in the heart as a result of platelet binding and aggregation followed by formation of bulky fibrin tails in which RBC’s become enmeshed?
Red thrombus
What thrombus is a pathologic condition associated with local ischemia due to arterial occlusion and can lead to ACS?
White
What are the three classes of drugs used in thromboembolic disorders?
- Antiplatelet drugs to prevent white thrombi
- Anticoagulants to prevent red thrombi
- Thrombolytics to destroy formed clots
Which drugs will be most efficacious in preventing thrombus formation in arteries?
- Anticoagulant
- Antiplatelet
- Thrombolytic
- Antiplatelet agent
What is the antiplatelet drug tha inhibts thromboxan A2 synthesis?
Aspirin
MOA of aspirin?
- Irreversible inhibition of cyclooxygenase to bloc TxA2 production which is a potent inducer of platelet aggregation
Clinical use of aspirin?
- started asap in acute coronary events
- secondary prevention of coronary events
AE of aspirin?
GI bleeding and hypersensitivity
MOA of the ADP (P2Y12) receptor blockers?
- cAMP prevents platelet aggregation
- ADP activates P2Y12 receptor a GPCR coupled to Gi protein this inhibits adenylyl cyclase and reduces cAMP
Clopidogrel metabolism and resistance?
- CYP2C19 metabolizes this prodrug into its active metabolite
- Those who have a nonfunctional CYP2C19 have resistance to this drug
Clinical use of P2Y12 receptor blockers?
- Started ASAP with acute coronary events
- Used alone in patients with aspirin hsn reactions
- Secondary prevention in patients with history of acute coronary events
How do Glycoprotein IIB/IOIIA inhibitors work?
- Platelet glycoprotein (GP) IIB/IIIA is an integrin that binds to extracellular ligands to trigger platelet aggregation
- These drugs prevent binding of ligands to the GP IIb/IIIa receptor
- Prevents aggregation of platelets
Clinical use of GP IIV/IIIA inhibitors?
- Use declined in USA
- Used during PCI in high risk patients
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65 yo man leaving hospital after an MI received an appropriate post discharge therapy that included aspirin low dose once daily. Which of the following actions most likely mediates the therapeutic effect of the drug in this patients disease?
- Competitive inhibition of cyclooxygenase
- Competitive inhibition of lipoxygenase
- Irreversible inhibition of ADP receptors
- Activation of GP IIb/IIIa receptor complex
- Irreversible acetylation of cyclooxygenase
- Irreversible acetylation of cyclooxygenase
Describe how streptokinase works?
- SK is a protein produces by streptococci that binds and activates plasminogen to activate it
Clinical uses of Thrombolytic drugs?
- Used if PCI cannot be performed in timely manner
- Used in STEMI and lessoften in NSTEMI w/n 12 hrs
AE of thrombolytics?
- Bleeding especially with SK causing systemic fibrinogenolysis
- allergic reactions to SK
