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Summary Anti-coagulants and Anti-platelets
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Anti-coagulants and Anti-platelets
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Anti-coagulants and Anti-platelets (Do you like drugs? Ido.)
Platelet Inhibitors
o Aspirin
o Abciximab
o Clopidogrel
o Dipyridamole
Anticoagulants
o Heparin
o Warfarin
o Fondaparinux
Thrombolytic agents
o Alteplase
o Streptokinase
Drug
o Therapeutic Action
ADP, Thrombin, Collagen PL Arachidonic acid –
Cycloxegenase 1 PGH2 TxA2
Asprin inhibits thromboxane A2 synthesis by acetylation of
a serine residue on the active site of COX-1
Balance of chemical mediators favor antiaggregatory
effects of prostacyclin
Lasts for the life of the platelet 7-10 days
o Therapeutic Use
, Prophylactic treatment of transient cerebral ischemia
Reduce incidence of recurrent MI
Decrease mortality in primary and secondary prevention of
MI
Dose 75mg daily
Range of dose is 50mg-325mg
o Adverse Effects
Angioedema
Bleeding
Bronchospasm
GI disturbances
Reyes syndrome
SJS
o Pharmokinetics
Oral
Passive diffusion
Hydrolyzed to salicylic acid in first pass metabolism in liver
Further metabolized in liver
Excreted in urine
Aspirin half-life: 15-20 minutes
Salicylic acid half-life: 3-12hrs
o Drug-Drug interactions/ Contraindications
Ketorolac-increased bleeding
Cidofovi-nephrotoxicity
Probenecid-decreased uricosuric effects
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