AntiPlatelet

Question 1

Platelet degranulation release what

Answer 1

ADP, 5HT, and more

Question 2

Platelet secretion releases what?

Answer 2

TXA

Question 3

which step if blocked stops coagulation

Answer 3

4th crosslinking

Question 4

PAR-1 and TP Pathway

Answer 4

q -> PLC -> DAG + IP3, DAG to PKC, IP3 to CA | CA to [PLA2] to make AA from phospholipids, [COX1] take AA to make TXA to trigger TP ( makes q to make PLC) | betagamma from PAR-1 and TP make GP-2b/3a activation

Question 5

P2y-12 pathway

Answer 5

ADP -> i inhbits adenylyl cyclase -> cAMP inhibits 1-4 | PDE inhibts cAMP [want cAMP]

Question 6

COX -1 COX-2

Answer 6

1 stomach and TXA 2 PGI and blood vessels

Question 7

Asprin

Answer 7

irreve and non select but more on cox-1, longest effect bc life of platelet and usually taken at breakfast to avoid DDI

Question 8

NSAID

Answer 8

non select reversible, due to this no thera platelet blocking

Question 9

Celecoxib

Answer 9

selective 2 but increased clotting risk, used to avoid Cox-1 stomach stuff

Question 10

Clopidogrel

Answer 10

Thienopyridines (P2y12) - 2 step (CYP 2C19)
2hr onset
DDI WITH OMEP
Irreversible
Q24H

Question 11

Prasugrel

Answer 11

Thienopyridines (P2y12) 1 step by (3A4, 2B6)
30 MIN ONSET
Irreversible
Q24H

Question 12

Ticagrelor

Answer 12

reversible P2y12 inhibitor
BID
8hr HL
30 min onset

Question 13

Cangrelor

Answer 13

reversible P2y12 inhibitor
IV
5min HL
2 min onset

Question 14

Dipyridamole, Cilostazol

Answer 14

PDE inhibit
Cil - for claudiaction
Dip - for 2nd stroke

Question 15

Vorapaxar

Answer 15

PAR-1 inhibitor Reversible
3-4 day HL

Question 16

SSRI

Answer 16

block 5HT
INCREASE GI BLEEDS
not used for therapy but more for side effect warning

Question 17

Abciximab

Answer 17

Blocks Gp-2a/3b (IRREVERSIBLE LIKE)
antibody fragment
30 HL and 7day effect
PROTEOLYTIC

Question 18

Eptifibatide

Answer 18

Blocks GP-2a/3b - reversible
cyclic 7 blocker
2.5 hr HL
effect 4-8hrs
RENAL ELIMINATION 50%

Question 19

Tirofiban

Answer 19

GP3
reversible nonpeptide
renal eliminated 65%
4-8hr effect