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7 Cards in this Set
- Front
- Back
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Antiplatelet types
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COX inhibitors
Phosphodiesterase inhibitors ADP receptor pathway inhibitors GPIIb/IIIa antagonists |
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Cox inhibits...
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Prostocyclin
Thromboxane A2 |
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ADP Receptor Inhibitors
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Ticlopidine (Ticlid)—1st generation
Clopidogrel (Plavix)—2nd generation Prasugrel (Effient)—3rd generation |
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Ticlopidine (Ticlid)
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Prodrug
Maximal platelet inhibition within 8-11 days, or 4-7 days with aspirin Loading dose AE: neutropenia, thrombocytopenia, TTP Monitor CBC frequently Less tolerable and slower onset of action compared to clopidogrel |
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Clopidogrel (Plavix)
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Prodrug
Metabolized to its active form by CYP 2C19 Poor metabolizers by genetic differences Drugs that inhibit 2C19 (e.g., PPI) Loading dose Lack of significant hematologic effects GI adverse effects similar to aspirin |
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Prasugrel (Effient)
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Prodrug
More complete inhibition of P2Y(ADP) receptor More efficiently metabolized Higher concentrations of active drug Increased risk of bleeding |
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GPIIb/IIIa Antagonists
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Eptifibatide, abciximab, tirofiban are IV
GPIIb/IIIa receptors part of the final common pathway of platelet aggregation Adverse effects: bleeding Abciximab—irreversible—fresh platelet infusion Eptifibatide, tirofiban—reversible and greatly outnumbers receptors—await drug clearance |
