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    Anti Platelets FKFKFK

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    Indah Pujiati Dt
    This document discusses several classes of antiplatelet drugs (anti-thrombotics) including: 1) arachidonic acid pathway inhibitors like aspirin, 2) phosphodiesterase inhibitors like dipyridamol, 3) ADP pathway inhibitors like ticlopidine and clopidogrel, and 4) glycoprotein IIb/IIIa inhibitors like abciximab, tirofiban. These drugs are used to prevent thrombosis in conditions like heart attacks, strokes, angioplasty and stent placement by inhibiting platelet aggregation and adhesion. Common side effects include bleeding and gastrointestinal issues.

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    © All Rights Reserved
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    Anti Platelets FKFKFK

    Uploaded by

    Indah Pujiati Dt
    85 views17 pages
    This document discusses several classes of antiplatelet drugs (anti-thrombotics) including: 1) arachidonic acid pathway inhibitors like aspirin, 2) phosphodiesterase inhibitors like dipyridamol, 3) ADP pathway inhibitors like ticlopidine and clopidogrel, and 4) glycoprotein IIb/IIIa inhibitors like abciximab, tirofiban. These drugs are used to prevent thrombosis in conditions like heart attacks, strokes, angioplasty and stent placement by inhibiting platelet aggregation and adhesion. Common side effects include bleeding and gastrointestinal issues.

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    Anti Platelets fkfkfk

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    This document discusses several classes of antiplatelet drugs (anti-thrombotics) including: 1) arachidonic acid pathway inhibitors like aspirin, 2) phosphodiesterase inhibitors like dipyridamol, 3) ADP pathway inhibitors like ticlopidine and clopidogrel, and 4) glycoprotein IIb/IIIa inhibitors like abciximab, tirofiban. These drugs are used to prevent thrombosis in conditions like heart attacks, strokes, angioplasty and stent placement by inhibiting platelet aggregation and adhesion. Common side effects include bleeding and gastrointestinal issues.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    85 views17 pages

    Anti Platelets FKFKFK

    Uploaded by

    Indah Pujiati Dt
    This document discusses several classes of antiplatelet drugs (anti-thrombotics) including: 1) arachidonic acid pathway inhibitors like aspirin, 2) phosphodiesterase inhibitors like dipyridamol, 3) ADP pathway inhibitors like ticlopidine and clopidogrel, and 4) glycoprotein IIb/IIIa inhibitors like abciximab, tirofiban. These drugs are used to prevent thrombosis in conditions like heart attacks, strokes, angioplasty and stent placement by inhibiting platelet aggregation and adhesion. Common side effects include bleeding and gastrointestinal issues.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    Antiplatelet Drugs

    (Anti-thrombotics)

    Classification
    1.Arachidonic acid pathway inhibitors e.g aspirin
    2. Phosphodiesterase inhibitors e.g. dipyridamol
    3. ADP pathway inhibitors.
    Ticlopidine- Clopidogrel
    4. Glycoprotein IIb/IIIa inhibitors.
    Abciximab, tirofiban
    Platelet aggregation
    Uses
    1. Prophylaxis of venous thrombosis.
    2. Transient cerebral ischemic attacks.
    2. Following coronary artery bypass grafting.
    3. Prevention of myocardial infarction.
    4. Following coronary artery angioplasty.
    5. Prosthetic heart valves.
    6. Chronic disseminated intravascular coagulation.
    Aspirin ( Acetylsalicylic Acid )
    Mechanism of Action
    1.Irreversible inhibition of cyclooxygenase
    enzyme via acetylation.
    2.Small dose inhibits thromboxane
    synthesis in platelets (TXA2) But not
    prostacyclin (PGI2) synthesis in
    endothelium (larger dose).
    Side effects
    1. Peptic Ulcer.
    2. Increased incidence of GIT bleeding

    Uses
    Prophylaxis of myocardial infarction
    ADP pathway inhibitors
    Ticlopidine & Clopidogrel

    Mechanism of Action
    Inhibits the binding of ADP to its platelet
    receptor by irreversibly modifying the
    platelet ADP receptor.
    Pharmacokinetics of ticlopidine
     Given orally.
     Extensively bound to plasma proteins.

     Metabolized in the liver to give active


    metabolites.
     Slow onset of action (3 - 5 days).
     is taken twice ( 250 mg twice daily ).
    Adverse Effects
    1.Sever neutropenia.

    2. Bleeding (Prolong bleeding time).

    3. CYT P450 inhibitors


    4.G.I.T : Diarrhoea, Nausea, Dyspepsia.

    5.Allergic Reactions.

    Monitoring of blood count every month is


    essential.
    Clopidogrel
    1. Clopidogrel is more potent.
    2. Less side effects ( less neutropenia).
    3. Less Frequency (75 mg once daily).
    4. Bioavailability is unaffected by food.
    Clinical Uses
    Alternative prophylactic therapy to aspirin in
    secondary prevention of stroke and myocardial
    infarction and unstable angina.
    Dipyridamole
    Phosphodiestrase inhibitor thus  cAMP in the
    blood platelets  inhibition of platelet aggregation.

    AMP  cAMP  degradation of cAMP


    Uses
     Taken orally.
     Primary prophylaxis in patients with prosthetic
    heart values ( in combination with warfarin ).
     As prophylactic therapy to treat angina pectoris
    in combination with aspirin .

    Disadvantages : Headache
    Advantage : No excess risk of bleeding
    Glycoprotein IIb/ IIIa receptor inhibitors

    Glycoprotein IIb/ IIIa receptor


     Is a receptor for fibronectin, fibrinogen,
    vitronectin and von Willebrand factor.
    Glycoprotein IIb/ IIIa receptor inhibitors
    1. Abciximab
     a monoclonal antibody that inhibits glycoprotein
    IIb/ IIIa receptor.
     It inhibits all the pathways of platelet activation
    (Final common pathway).
     Given I.V. infusion

     adjuncts to heparin and aspirin for prevention of


    cardiac ischemic complications.
     Side effect is immunogenicity
    Glycoprotein IIb/ IIIa receptor inhibitors
    Tirofiban & Eptifibatide. 2
     Eptifibatide (peptide)
     Tirofiban (non-peptide)
     are synthetic mimetics of arginine-glycine-
    aspartic sequence of fibrinogen
     inhibits glycoprotein IIb/ IIIa receptor at site
    that interacts with arginine-glycine-aspartic
    sequence of fibrinogen (by occupancy of the
    receptor) fibrinogen like mimetic agent.
     Given I.V.
     Acute coronary syndromes to decrease
    incidence of thrombotic complications

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