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Antiplatelet Drugs and Thrombolytics - Update
Pharm Assessment 14
23
Pharmacology
Graduate
02/27/2012

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Cards

Term
What drugs are most effective in preventing arterial thrombosis, and generally less effective in preventing venous thrombosis?
Definition
Antiplatelet Drugs

Aspirin, clopidogrel
Term
What drugs prevent both arterial and venous thrombosis?
Definition
Anticoagulants
(Heparin and Warfarin)
Term
What drugs lyse both arterial and venous thrombi?
Definition
Thrombolytics

(streptokinase, tPA)
Term
How does Aspirin exert its therapeutic effects? (antipyretic, antiinflammatory, analgesic, and antiplatelet)
Definition
Inhibiting cyclooxygenase (COX)
that produces prostaglandins
Term
What does inhibition of COX1 prevent?
Definition
synthesis of Thromboxane
Term
What does inhibition of COX2 prevent?
Definition
Synthesis of PGI2
Term
How does Aspirin irreversibly inhibit platelet aggregation?
Definition
by acetylating COX-1

Half-life - 4-7 days(time required to make new platelets)
Term
What are the contraindications for Aspirin?
Definition
Coumarin anticoagulants (increased bleeding risk)
Peptic Ulcer Disease
Aspirin Hypersensitivity (Asthma)
Term
Why should aspirin be used for its antiplatelet effect over other NSAIDs?
Definition
Other antiinflammatory drugs don not inhibit platelet function sufficiently to be protective and may interfere with aspirins effect
Term
What is the Phosphodiesterase Inhibitor?
Definition
Dipyridamole
Term
What is the mechanism of the Phosphodiesterase inhibitors?
(Dipyridamole)
Definition
Inhibits enzyme that degrades cyclic AMP -> Increased platelet cAMP -> inhibits aggregation
Term
What disease is the combination of aspirin and dipyridamole show added benefit in?
Definition
Cerebrovascular disease
Term
What does Clopidorgrel inhibit?
Definition
Inhibit ADP receptor-mediated activation of platelets
Term
What ADP antagonist has a significantly increased risk of postoperative bleeding?
Definition
Clopidogrel
Term
What drug is marginally more effective than aspirin and may have greater effect in patients with peripheral arterial disease?
Definition
Clopidogrel
Term
What is the receptor on platelets that fibrinogen binds to and links paltelets to form platelet plug?
Definition
Glycoprotein IIb/IIIa
Term
What are the GpIIb/IIIa receptor inhibitors?
Definition
Eptifibidate
Abciximab
Term
What are the Thrombolytics?
Definition
1st Generation
Streptokinase

2nd Generation
t-PA
Term
What thromboylitic was isolated from hemolytic streptococci and is strongly immunogenic?
Definition
Streptokinase
Term
Why can Streptokinase only be administered once?
Definition
Strongly immunogenic -> antistreptokinase antibodies

Cause serum sickness, hypotension, fever, rash, bronchospasm angioedema, anaphylaxis

Ab May inactivate Streptokinase
Term
What thrombolytic is a naturally-occuring protein released by vascular endothelial cells?
Definition
t-PA
Term
What should be used after thrombolytic therapy to prevent reocclusion?
Definition
ASA/Heparin Therapy
Term
What is the most serious side effect of thrombolytics?
Definition
intracranial hemorrhage
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