Antiplatelets Flashcards
Aspirin
- interfere with platelet aggregation or stickiness
- used to prevent clot formation in arteries
ASA
- single dose- antiplatelet effects up to one week!
- irreversible inhibition of cyclooxygenase
- used to prevent heart attack, TIA, stroke
- 81 mg is all needed for prevention
Huge risk of GI bleeding with….
- Asprin
- add PPI with med
- enteric coated med does not prevent this
ADP Antagonist
Prototype: clopidogrel (plavix)
MOA: irreversible blockade of ADP receptors on platelet surfaces
Use: to prevent clots-> MI, CVA
SE: same as ASA
ACS patients will be given an ADP antagonist along with
an ASA
- DAP
- Used with stenting
genetic variant issue with clopidogrel?
- CYP2C19
- poor metabolizers should use another ADP
Drug interaction o ADP
PPI but still given
Clopidogrel s/s
bleeding
- check with provider first before stopping
- increase risk of thrombotic event
Should clopidogrel be stopped before surgery
yes 5 days before
PAR- 1 Antagonist
Prototype: vorapaxar (Zontivity)
MOA: reversibly blocks the PAR-1 expressed on platelets
-Oral
- Lasts 7-10 days after last dose
-Given with clopidogrel and or ASA to prevent CV events
Glycoprotein IIb/IIIa Receptor Antagonists
“Super aspirins”
- Prototype: abciximab (ReoPRo)
- IV admin
- Short term use : during cardiac cath/ balloon angioplasty/ stents , ACS
- Reversible inhibition of all factors in platelet aggregation
- Given with ASA and heparin
- works 24-48 hours after stopping
- high risk of bleeding
Thrombolytics
- Break down clots (lysis)
- Prototye: alteplase (tPa)
- Most effective if given early: within 6 hours MI (30 min) and within 3 hours of CVA
- Narrow margin of safety
- Any s/s of bleeding stop! esp cerebral (change in LOC)
- Half-life is 5 mins
Contraindication of tPa
- risk of hemmorhage is low in patinets receiveing tPa if patients are screened properly
- pregnancy
- internal bleeding
- severe HTN
- other anticoagulants
- ## PUD risk
