Summary Anti-coagulants and Anti-platelets

Anti-coagulants and Anti-platelets (Do you like drugs? I
do.)

 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




2