Session 8 - Anti-platelets, Thrombolysis and IHD Flashcards
What are the two main indications for aspirin?
Prevention and treatment of MI / Ischaemic stroke
Analgesic & Anti-inflammatory agent
Give five main contraindications for aspirin?
Children under 12 years who are at risk of Reye’s Syndrome
Breastfeeding, Haemophilia, peptic ulcers, known hypersensitivity
How is aspirin an anti-platelet?
Prevents the formation of Thromboxane A2 from Arachidonic Acid in platelets. Thromboxane A2 stimulates phospholipase C, increasing calcium levels and causing platelet aggregation
Give two aspirin ADRs
Bronchospasm, GI haemorrhage
Give two ways in which aspirin interacts with a particular drug?
Displaces Warfarin from plasma proteins (PKs)
Increases Anti-Coagulant effect of Warfarin at a different site (PDs)
Give two anti-platelets other than aspirin
Dipyridamole
Copidogrel
What is the indication for dipyridamole?
Used in conjunction with warfarin in prophylaxis against thrombosis due to prosthetic mechanical heart valves
What is the mech of action of dipyridamole?
Inhibits Phosphodiesterase enzyme
Phosphodiesterase increases cAMP, which increases Ca2+, which causes platelet aggregation
Give three adverse drug reactions to dipyridamole?
Hypotension, nausea, diarrhoea, headache
What is the main use of clopidogrel?
Can be used if patient allergic to aspirin
HOw does clopidogrel work?
ADP Antagonists
Inhibits ADP-ADP receptor interaction, which aids platelet aggregation
What is glycoprotein IIb and IIIa used for?
Prevention of ischaemic cardiac complications in patients undergoing Percutaneous Coronary Intervention (PCI)
Short term prevention of MI in unstable angina patients
What is the mech of action of glycoprotein IIb?
Monoclonal Antibody to Glycoprotein IIb/IIIa Receptors
Prevents platelet aggregation
What is the normal clearance method of fibrin?
Plasmin cleaves fibrin, fibrinogen and other coag factors
What is plasmin formed from?
Plasminogen