Pharm: Antiplatelet Drugs Flashcards Preview

MHD/Pharm Block 4 > Pharm: Antiplatelet Drugs > Flashcards

Flashcards in Pharm: Antiplatelet Drugs Deck (26):
1

What is the general mechanism of anti-platelet drugs?

Inhibition of primary hemostatic plug formation, aggregation, activation and release mechanisms

2

Describe the contents of light and dark granules

Light: PF4, beta-thromboglobulin, PDGF
Dark: Ca2+, Serotonin, ATP/ADP

3

What are the products of platelet activation and endothelial interaction?

Prostaglandin derivatives
Endoperoxides
Thromboxanes

4

What site do anti-platelet have activity in that anticoagulants do not?

The arterial circulation

5

What are the main classes of antiplatelet agents?

1) Aspirin
2) COX inhibitors
3) NSAIDs
4) ADP receptor inhibitors
5) Dipyridamole
6) Cilostazol
7) GPIIb/IIIa inhibitors
8) Prostacyclin analogue

6

What are the most widely used ADP receptor inhibitors?

Clopidogrel and prasugrel

7

Which ADP receptor inhibitors are prodrugs that require liver transformation?

Ticlopidine, Clopidogrel and prasugrel

8

What is the effect of dipyridamole?

Coronary vasodilatation

9

What is the indication for Ciostazol?

Management of intermittent claudication

10

What are the drugs that inhibit GPIIb/IIIa receptors?

Tirofiban
Eptifibatide
Abciximab

11

What is the risk with aspirin resistance?

May cause recurrent ischemic vascular events in patients taking low dose aspirin

12

What is the mechanism of action of clopidogrel?

Selective inhibition of the ADP receptor, leading to inhibition of platelet aggregation

13

Describe the population variation of clopidogrel and prasugrel

Prasugrel has less population variation than clopidogrel. A significant portion of the population is non-respondant to clopidogrel due to a polymorphism.

14

Is antiplatelet monotherapy typically used?

No, dual antiplatelet therapy is often used because single target therapy is not sufficient.

15

What are the clinical applications of antiplatelet drugs?

Cerebrovascular disease (TIA, stroke)
Coronary artery disease (MI, unstable angina)
Saphenous vein coronary artery bypass grafts
Peripheral vascular disease
Small vessel disease
Prevention of thrombosis on artificial surfaces

16

What drugs interact with anti-platelet drugs?

Thrombolytic agents
Heparin/LMW heparin/Oral anticoagulants
Warfarin
Antithrombin agents

17

What are the two pathways of arachadonic acid metabolism?

Cyclooxygenase pathway to form PGs
Lipoxygenase pathway to form LTs

18

What are the main regulators of prostacyclin and thromboxane synthesis?

Endothelial lining
Lipoproteins and other blood components
Diet, drugs, hemodynamics

19

Describe the balance between PGI2 and TXA2 and how it is modulated

Healthy individuals should COX pathways that favor PGI2 over TXA2 in order to prevent clotting.

Aspirin blocks TXA2 formation in order to tip the balance in favor of PGI2

20

Describe the pharmacology of omega 3 fatty acid

Contains acids that compete with AA in the PG pathway in order to inhibit the effects of TXA2

21

Which antiplatelet drugs must be given via IV?

The GP IIb/IIIa inhibitors are the only antiplatelet drugs not given orally

22

What is the mechanism of action of dipyridamole and cilostazol?

Phosphodiesterase inhibitors

23

What are the eicosanoids?

Monteleukast
Zafirleukast
Zieuton

24

What is the mechanism of action of monteleukast and zafirleukast?

Leukotriene receptor inhibitors

25

What is the main side effect of the eicosanoids?

Hypotension

26

What antiplatelet drugs are used to treat asthma?

Zafirleukast and Zieuton

Treatment for "aZZma"