PLATELET AGGREGATION INHIBITORS

Question 1

groups of drugs included:

Answer 1

1. aspirin + other NSAIDs
2. antagonists of ADP receptors
3. GP (glycoprotein) IIb/IIIa receptor inhibitors
4. phosphodiesterase 3 inhibitors

Question 2

aspirin → mechanism of action:

Answer 2

1. inhibit thromboxane A2 synthesis by inactivating COX-1 enzyme
2. also anti-inflammatory & analgesic effects

Question 3

aspirin → indications:

Answer 3

PREVENTION of MI, TIAs, ischemic stroke & other thrombotic events

Question 4

aspirin → side effects:

Answer 4

1. angioedema
2. bronchospasm
3. reye syndrome
4. bleeding
5. GI-tract symptoms

Question 5

antagonists of ADP receptors:

Answer 5

1. ticlopidine
2. clopidogrel
3. prasugrel
4. ticagrelor

Question 6

antagonists of ADP receptors → indications:

Answer 6

1. prevention of TIAs & ischemic stroke
2. clopidogrel → used after coronary stent placement
3. prevention atherosclerotic events in MI

Question 7

antagonists of ADP receptors → side effects:

Answer 7

1. prolonged bleeding
2. NO antidote!!!!
3. granulocytosis, thrombotic thrombocytopenic purpura, aplastic anemia

Question 8

GP (glycoprotein) IIb/IIIa receptor inhibitors:

Answer 8

1. abciximab
2. tirofiban
3. eptifibatide

Question 9

GP IIb/IIIa receptor inhibitors → pharmacokinetics:

Answer 9

given IV → along with heparin & aspirin

Question 10

GP IIb/IIIa receptor inhibitors → indications:

Answer 10

1. prevention of restenosis after coronary angioplasty

2. treatment of acute coronary syndromes

Question 11

GP IIb/IIIa receptor inhibitors → side effects:

Answer 11

1. may worsen ischemia because of vasodilation
2. headache
3. orthostatic hypotension

Question 12

phosphodiesterase 3 inhibitors:

Answer 12

1. dipyridamole

2. cilostazol

Question 13

phosphodiesterase 3 inhibitors → mechanism of action:

Answer 13

1. inhibitors of phosphodiesterase 3 → vasodilation

2. increase cAMP → resulting in decreased thromboxane A2 synthesis

Question 14

phosphodiesterase 3 inhibitors → indications:

Answer 14

1. dipyridamole → with aspirin to PREVENT ischemic stroke, adjunct to warfarin in valve replacement
2. cilostazol → treat intermittent claudication

Question 15

phosphodiesterase 3 inhibitors → side effects:

Answer 15

1. headache
2. GI-tract problems
3. increase mortality in advanced heart failure (contraindicated)