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Flashcards in Antiplatelet Drugs Deck (27)
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1

What processes do antiplatelet drugs target?

1) primary hemostatic plug formation
2) aggregation
3) activation
4) release mechanisms

2

How is a platelet aggregation assay performed?

1) prepare PRP
2) activate platelets
3) measure light transmittance

light goes thru --> aggregation
no light thru --> no agg

3

What 3 things are released by light granules?

1) platelet factor 4
2) beta thromboglobulin
3) platelet derived growth factor (PDGF)

4

What 3 things are released by dark granules?

1) Ca++
2) Serotonin
3) ATP/ADP

5

What products are formed during platelet activation and endothelial interaction?

prostaglandin derivatives
endoperoxides
thromboxanes

6

Why is there a specific niche for antiplatelet agents that cannot be covered by heparin and oral anticoags?

antiplatelet drugs act in arterial circulation

7

What are antiplatelet drugs used for?

primary and secondary prevention of thrombotic cerebrovascular/cardiovasc diseases

8

Name the 4 classes of antiplatelet agents

1) Aspirin - decreased platelet agg
2) COX inhibitors
3) propionic acid derivatives (ibuprofen, naproxen)
4) ADP receptor inhibitors

9

What are the ADP receptor inhibitors?

Ticlopidine
Clopidogrel
Prasugrel
Ticagrelor
Cangrelor

10

True or false: all ADP receptor inhibitors are prodrugs and require transformation into active forms in the liver

TRUE (except for ticagrelor)

11

What is the primary function of antiplatelet drugs?

to decrease platelet aggregation in the arterial system

12

What drug is used for the management of intermittent claudication?

cilostazol

13

Every patient undergoing open heart surgery takes ________ because it is a coronary vasodilator

dipyridamole

14

What are the GP2b/3a inhibitors?

abciximab
tirofiban
eptifabatide

15

What likely causes aspirin resistance?

COX polymorphism

16

How does Clopidogrel act?

blocks ADP receptor so ADP cannot bind to the platelet and recruit more platelets

17

If a patient is not responding to clopidogrel, what do you do?

Give prasugrel

18

What is involved in dual antiplatelet therapy?

aspirin/ADP receptor inhibitors or GP2b/3a inhibitors or dipyridamole

19

What is involved in triple antiplatelet therapy?

aspirin/ADP receptor inhjbitor/cilostazol

20

what are the top 2 clinical applications of antiplatelet drugs?

1) Cerebrovascular disease (transient ischemic attack, complete stroke)
2) Cardiovascular disease (acute MI, unstable angina)

(also CABG, peripheral vascular disease)

21

True or false: drug interactions are minimal with antiplatelet drugs

FALSE they are profound (urokinase, streptokinase and tPA)

22

What are the 2 pathways arachidonic acid is metabolized?

1) COX (into prostaglandins)
2) lipoxygenase (leukotrienes)

23

What is the main mechanism by which aspirin mediates its therapeutic effects?

inhibits thromboxane formation in platelets

24

What is an inhibitor of the lipoxygenase pathway?

zileuton (used to treat asthma)

25

What are 2 leutotriene antagonists?

1) montelkast (asthma/allergies)
2) zarirlukast (asthma)

26

What exsmye is responsible for the formation of arachidonic acid?

phospholipase A2

27

True or false: fish oil has antiplatelet action

TRUE (forms inactive TXA2)