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RESUMEN DE ANTIAGREGANTES Y ANTIPLAQUETARIOS

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MECANISMO DE ACCIÓN DOSIS PROFILAXIS PRIMARIA Y SECUNDARIA INDICACIONES EFECTOS ADVERSOS

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  • June 6, 2023
  • 9
  • 2022/2023
  • Class notes
  • Dr. roger jaramillo
  • All classes
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SANGRE



Capa celular endotelial

PROCOAGULANTES
SANGRE
ANTICOAGULANTES (+):
En NOXA o lesión: Antitrombina III
• Se destruyen las células endoteliales Proteína C

Proteína S
1. fibras COLAGENO Heparina – Producida por Células
2. Activa FACTOR VON WILLEBRAND SEBADAS
Activan las sustancias PROCOAGULANTES DEFICIT- Infarto


HEMOSTASIA PRIMARIA o TAPON BLANCO

PLAQUETAS

Ocurre la Activación plaquetaria a través de 3 pasos:

1. ADHESION
2. ACTIVACION
3. AGREGACION PLAQUETARIA

1er paso

ADHESION PLAQUETARIA

El receptor de las plaquetas es activado por las
FC y FVW, se adhiere a la lesión-




2do paso

ACTIVACION
La membrana celular tiene vesículas
superficiales que hacen que esta MC se activen

• Tromboxanos A2 – Se activen FA2.
• ADP



FOSFODIESTERASA también activa la plaqueta

, Deben estar
CILOSTAZOL; vasoespasmo; Patológico (sin sintomatología) Clínico (con
asociados
sintomatología)- DIMODIPINA
para hacer
DIPIRIDAMOL puede estar asociado con WARFARINA
efectos


3er Paso

AGREGACION PLAQUETARIA


Vesículas: Glicoproteina IIB IIIA (cuando la
plaqueta se activa, se dirige a la superficie)




FÁRMACOS

ANTIAGREGANTE PLAQUETARIO

Los que actúan en la hemostasia primaria

AINES

• No se usan en sangrado activo
• Gastro lesivos- Ingerirlos después de comer
• Sangrados

ACIDO ACETIL SALICILICO

Mecanismo de acción : Bloquean TXA2- 7 días suspender el fármaco – BLOQUEO IRREVERSIBLE

TRIFUZAL – análogo de la aspirina

DOSIS; 81MG

• De mantenimiento: 100 MG
• De ataque: 300 MG – dar en etapa aguda de IAM, ECV (Como prevención primaria o
secundaria)

Mecanismo de acción: BLOQUEA ADP

Se metabolizan bien con alimentos

EFECTOS ADVERSOS: SANGRADO, NAUSEAS, VOMITO

TIENOPIRIDINAS- Bloqueo irreversible

1. TICLOPIDINA- Ya no se usa
2. PRASUGREL
3. CLOPIDOGREL + conocido
Mejor para prevención primaria y secundaria para IAM, ECV.

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