Antiplatelet and Anticoagulants Flashcards
(37 cards)
What is the difference between antiplatets and anticoagulants?
Anticoagulants slow down clotting, thereby reducing fibrin formation and preventing clots from forming and growing.
Antiplatelet agents prevent platelets from clumping and also prevent clots from forming and growing.
What drugs are considered antiplatets?
P2Y12 Inhibitors
Platet Aggreggation inhibitors
What are the different P2Y12 Inhibitors?
Clopidogrel (Plavix)
Ticagrelor (Brilinta)
Prasugrel (Effient)
How do the different P2Y12 Inhibitors work?
Clopidogrel/Prasugrel: Irreversibly and directly inhibits ADP binding to receptor sites, inhibiting subsequent activation of the glycoprotein IIb/IIIa complex
Ticagrelor: Reversibly and allosterically inhibits ADP binding to receptor sites, inhibiting subsequent activation of the glycoprotein IIb/IIIa complex
When cant you use the different P2Y12 Inhibitors?
All: Active bleeding
Ticagrelor: History of intracranial hemorrhage
Prasugrel: History of any TIA or stroke
What are the side effects associated with using P2Y12 Inhibitors?
bleeding, Thrombotic Thrombocytopenic Purpura(blood disorder characterized by the formation of small blood clots throughout the body, leading to a low platelet count)
What are the counseling points for the P2Y12 Inhibitors?
- Severe bleeding can occur but is rare. It is common to bruise more easily or take a little longer for minor cuts to stop bleeding. You should call your doctor if you have dark tarry stools (sign of digested blood), you cough up blood, or have a bleeding cut that won’t stop.
- Avoid taking with NSAIDs
What type of drug is Dipyridamole/Acetylsalicylic Acid?
platet aggreggation inhibitor
What is the brand name of Dipyridamole/Acetylsalicylic Acid?
Aggrenox
How does Dipyridamole/Acetylsalicylic Acid work?
Dipyridamole: Inhibits the uptake of adenosine into platelets, endothelial cells, and erythrocytes resulting in an increase in local concentrations of adenosine, which is a coronary vasodilator and a platelet aggregation inhibitor
Aspirin: Inhibits platelet aggregation by irreversible inhibition of platelet cyclooxygenase and thus inhibits the generation of thromboxane A2 (TXA2)
When cant you use Dipyridamole/Acetylsalicylic Acid?
Asthama
What are the side effects of Dipyridamole/Acetylsalicylic Acid?
- Headache (~40% of patients, tolerance can be built overtime)
- Nausea
- Diarrhea
- Bleeding
- Bronchospasm
- Drug reaction with eosinophilia and systemic symptoms (DRESS)
What medications are considered anticoagulants?
Factor Xa inhibitors
Direct Thrombin Inhibitor
Low Molecular Weight Heparin
Vitamin K antagonist
What drugs are considered Direct thrombin inhibitors?
Apixaban (Eliquis), Rivaroxaban (Xarelto)
How does apixaban work?
Selective inhibitor of factor Xa which decreases thrombin generation and thrombus development.
When dont you use apixaban?
Active bleeding
What are the BBW associated with apixaban?
- Premature discontinuation increases risk of thrombotic events
- Increased risk of spinal hematoma with spinal puncture or neuraxial anesthesia
What are the side effects of apixaban?
bleeding including epistaxis, heavy menstrual bleeding, gingival hemorrhage
What type of drug is Dabigtran
direct thrombin inhibitor
What is the brand name of Dabigtran?
Pradaxa
How does dabigtran work?
Competitive, reversible, direct thrombin inhibitor which blocks the conversion of fibrinogen into fibrin during the coagulation cascade and prevents development of a thrombus
When dont you use Dabigtran?
Active Bleeding
Prosthetic heart valve
What are the BBW associated with Dabigtran?
- Premature discontinuation increases risk of thrombotic events
- Increased risk of spinal hematoma with spinal puncture or neuraxial anesthesia
What are the side effects of Dabigtran?
bleeding including epistaxis, heavy menstrual bleeding, gingival hemorrhage, Dyspepsia
