Antiplatelet (aka antiaggregant) are drugs that decrease platelet aggregation and inhibit thrombus formation.
Patient information
Antiplatelets means that someone ain't like platelets. What are platelets?
Platelets are disc shaped fragments of cytoplasm, that are found in blood, involved with blood clotting. So antiplatelets are drugs that prevent platelets from aggregating, and therefore blood from clotting.
Purpose
Widely used in primary and secondary prevention of thrombotic cerebrovascular or cardiovascular disease
Classification
Irreversible COX inhibitors:
Aspirin
Triflusal (Disgren)
ADP receptor inhibitors:
Clopidogrel (Plavix), which is an oral drug used to inhibit blood clots in CAD, peripheral vascular disease, cerebrovascular disease, and to prevent MI. It works by irreversibly inhibiting a receptor P2Y12, an ADP chemoreceptor on platelet cell membranes. Side effects include bleeding, severe neutropenia, and thrombotic thrombocytopenic purpura
Prasugrel (Effient)
Ticagrelor (Brilinta)
Ticlopidine (Ticlid)
Phosphodiesterase inhibitors:
Cilostazol (Pletal)
PAR-1 antagonists:
Vorapaxar (Zontivity)
Glycoprotein IIB/IIIA inhibitors (IV use only):
Abciximab (ReoPro)
Eptifibatide (Integrilin)
Tirofiban (Aggrastat)
Adenosine reuptake inhibitors:
Dipyridamole (Persantine)
Thromboxane inhibitors:
Thromboxane synthase inhibitors
Thromboxane receptor antagonists
Terutroban
Side effects
Low dose aspirin increases the risk of major bleeding 2-fold compared w/ placebo
Drug toxicitiy may be increased when multiple antiplatelets are used
GI bleeding is a common adverse event seen in many Pt's
Epidemiology
Annual incidence of major bleeding due to low-dose aspirin is modest, only 0.13% higher than what is observed with placebo. Thus, Tx of Pt's w/ low-dose aspirin annually for cardiovascular prophylaxis will result only in 0.125% additional major bleeding episode
Before the expiry of the Clopidogrel patent, it was the 2nd best selling drug in the world, grossing $9bn in global annual sales
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