Anti platelet drugs Flashcards
Normal (Resting) State
In the “normal”, intact blood vessel there is a constant balance between hemostasis and thrombolysis
main components of Normal (Resting) State
Endothelial cells
Platelets
Circulating coagulation/thrombolytic factors
PAR-1 Antagonist drug
Vorapaxar (Zontivity)
Vorapaxar (Zontivity) MOA
MOA: blocks the protease-activated receptor (thrombin receptor) on platelets to inhibit aggregation
Vorapaxar (Zontivity)/PAR-1 Antagonist drug use
history of MI or PAD with ASA and/or clopidogrel
PAR-1 Antagonist BBW
Use is contraindicated in patients with history of stroke, TIA, or ICH; or active pathological bleeding.
Vorapaxar increases the risk of bleeding, including ICH and fatal bleeding.
Phosphodiesterase Inhibitors
Dipyridamole (Persantine)
Cilostazol (Pletal)
Dipyridamole (Persantine) MOA
Inhibits the activity of adenosine deaminase and phosphodiesterase, which causes an accumulation of adenosine, adenine nucleotides, and cyclic AMP
May also stimulate release of prostacyclin
Causes coronary vasodilation
Dipyridamole (Persantine) use
Oral: Used with warfarin to decrease thrombosis in patients after artificial heart valve replacement
I.V.: Diagnostic agent in CAD (Persantine Stress Test)
Dipyridamole (Persantine) ADR:
Bleeding risk
Orthostasis (especially in elderly)
Cilostazol (Pletal) MOA
Cilostazol and its metabolites are inhibitors of phosphodiesterase III
Cilostazol (Pletal) use
Symptomatic management of peripheral vascular disease, primarily intermittent claudication
Cilostazol (Pletal) BBW
use in HF
Cilostazol (Pletal) dDI
many with hepatic metabolism
Glycoprotein IIb/IIIa Inhibitors
Abciximab (ReoPro)
Eptifibatide (Integrilin)
Tirofiban (Aggrastat)
