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Flashcards in Antiplatelet Drugs Deck (51)
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1
Q

What are the release products of the light (alpha) granules?

A

Platelet factor 4
Beta-thromboglobulin
Platelet-derived growth factor (PDGF)

2
Q

What are the release products of the dense (beta) granules?

A

Ca+2
Serotonin (5-Hydroxytryptamine)
ATP/ADP

3
Q

Is primary aggregation reversible? Is secondary?

A

Primary aggregation is reversible but secondary is NOT.

4
Q

What are the functions of the anti platelet drugs?

A

An antiplatelet drug is a member of a class of pharmaceuticals that decreases platelet adhesion, activation and aggregation thereby inhibit thrombus formation.

5
Q

What is the difference in effectiveness of the anti-platelet drugs in the arterial circulation VS drugs like heparin and warfarin?

A

These drugs are effective in the arterial circulation, where anticoagulants such as heparin and oral anticoagulants have relatively little effect.

6
Q

What is the general usage of anti-platelet drugs?

A

They are widely used in primary and secondary prevention of thrombotic cerebrovascular or cardiovascular disease

7
Q

Which of the ADP receptor inhibitors are prodrugs?

A

Ticlopidine
Clopidogrel
Prasugrel

8
Q

What is the difference between these two ADP receptor inhibitors: Ticagrelor and Cangrelor?

A

Cangrelor is available via IV only whereas Ticagrelor is oral

9
Q

What is the most potent class of anti platelet drugs?

A

GPIIb/IIIa Inhibitors

10
Q

What are the COX inhibitors?

A

Aspirin
Celecoxib (COX2 only)
Ibuprofen
Naproxen

11
Q

What are the ADP receptor inhibitors?

A
Ticlopidine
Clopidogrel 
Prasugrel 
Ticagrelor
Cangrelor
12
Q

What are the GP IIb/IIIa inhibitors?

A

Abciximab
Tirofiban
Eptfibatide

13
Q

What is a PAR-1 antagonist?

A

Vorapaxar

14
Q

What is the difference between the ADP receptor inhibitors Clopidogrel and Prasugrel?

A

Prasugrel has less population variation in response to treatment so it is more likely to be effective in patients.

15
Q

How is anti platelet therapy generally administered?

A

Dual Antiplatelet Therapy as combination therapy often with aspirin. Sometimes even Triple Therapy is used.

16
Q

What are some of the clinical applications of anti-platelet drugs?

A
  • Cerebrovascular disease:
    a. Transient ischemic attack (TIA)
    b. Complete stroke
  • Coronary artery disease:
    a. Acute myocardial infarction
  • Saphenous vein coronary artery bypass grafts
  • Venous Thrombosis
  • Claudication
  • Thrombotic thrombocytopenic purpura
  • Prevention of thrombus formation on artificial surfaces
17
Q

What are some drugs that possibly have interaction with anti-platelet drugs?

A
  1. Thrombolytic agents (urokinase, streptokinase and tissue plasminogen activator)
  2. Heparin/LMW heparin/oral anticoagulants
  3. Warfarin
  4. Antithrombin agents (hirudin, bivalirudin and argatroban)
18
Q

What are the two major pathways of arachidonic acid metabolism?

A
  1. Cyclooxygenase pathway

2. Lipoxygenase pathway

19
Q

What is the main drug that acts on the Cyclooxygenase Pathway?

A

Aspirin

20
Q

What are the main products of the Cyclooxygenase Pathway in platelets?

A

TXA2

21
Q

What is the main product of the Lipoxygenase Pathway in leukocytes?

A

Leukotrienes

22
Q

What are the leukotriene antagonists and what are they used for?

A
  • Montelukast is used for the treatment of asthma and seasonal allergies
  • Zarirlukast is used in the treatment of asthma
23
Q

Aspirin MOA and Route of Administration

A

COX inhibitor

Oral

24
Q

Aspirin Indications

A

ACS, stroke, arterial thrombosis

25
Q

Aspirin SE

A

Bleeding

Gastric Irritation

26
Q

Clopidegrel MOA and Route of Administration

A

ADP receptor inhibitor

Oral

27
Q

Clopidogrel Indications

A

ACS, stroke, in stent thrombosis

28
Q

Clopidogrel SE

A

Bleeding, TTP

29
Q

Prasugrel and Ticagrelor MOA and Route of Administration

A

ADP receptor inhibitor

Oral

30
Q

Prasugrel and Ticagrelor Indications

A

ACS, stroke, in stent thrombosis

31
Q

Prasugrel and Ticagrelor SE

A

Bleeding

32
Q

NSAIDs MOA and Route of Administration

A

COX inhibitor

Oral

33
Q

Dipyridamole MOA and ROA

A

Phosphodiesterase inhibitor

Oral

34
Q

Dipyridamole Indications

A

Arterial thrombosis, stroke

35
Q

Dipyridamole SE

A

Bleeding

36
Q

Cilostazol MOA and ROA

A

Phosphodiesterase inhibitor

Oral

37
Q

Cilostazol Indications

A

Intermittent claudication

38
Q

Cilostazol SE

A

Hypotension

39
Q

Abciximab/Eptifibatide/Tirofiban MOA and ROA

A

GP IIb/IIIa inhibitor

IV

40
Q

Abciximab/Eptifibatide/Tirofiban Indications

A

ACS

Coronary Heart Disease

41
Q

Abciximab/Eptifibatide/Tirofiban SE

A

Bleeding

42
Q

Monteleukast MOA and ROA

A

Leukotriene receptor inhibitor

Oral

43
Q

Monteleukast Indications

A

Allergic reactions

44
Q

Monteleukast SE

A

Hypotension

Behavioral Changes

45
Q

Zafirleukast MOA and ROA

A

Leukotriene receptor inhibitor

Oral

46
Q

Zafirleukast Indications

A

Asthma

47
Q

Zafirleukast SE

A

Hypotension

48
Q

Zieuton MOA and ROA

A

Lipoxygenase inhibitor

Oral

49
Q

Zieuton Indications

A

Asthma

50
Q

Zieuton SE

A

Hypotension

51
Q

Which of the following mechanisms represents the antiplatelet actions of Diprydamole?

A. ADP receptor inhibition
B. Cyclooxygenase inhibition
C. Glycoprotein IIb/IIIa inhibition 
D. Lipoxygenase inhibition
E. Phosphodiesterase inhibition
A

E. Phosphodiesterase inhibition

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