Platelet aggregation inhibitors: Difference between revisions
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==Classification== | ==Classification== | ||
===Adenosine diphosphate (ADP) blocker=== | ===Adenosine diphosphate (ADP) blocker=== | ||
====Thienopyridines==== | |||
[[Thienopyridines]] include [[clopidogrel]], [[ticlopidine]], and the prodrug [[prasugrel]].<ref name="pmid19821273">{{cite journal| author=Sudlow CL, Mason G, Maurice JB, Wedderburn CJ, Hankey GJ| title=Thienopyridine derivatives versus aspirin for preventing stroke and other serious vascular events in high vascular risk patients. | journal=Cochrane Database Syst Rev | year= 2009 | volume= | issue= 4 | pages= CD001246 | pmid=19821273 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&[email protected]&retmode=ref&cmd=prlinks&id=19821273 | doi=10.1002/14651858.CD001246.pub2 }}</ref> They inhibit the ADP receptor. | |||
===Cyclooxygenase-1 blockers=== | ===Cyclooxygenase-1 blockers=== | ||
Cyclooxygenase-1 blockers include [[aspirin]]. | Cyclooxygenase-1 blockers include [[aspirin]]. | ||
===Thromboxane-A synthase inhibitors=== | |||
This includes [[dipyridamole]]. | |||
===Glycoprotein IIb/IIIa inhibitors=== | ===Glycoprotein IIb/IIIa inhibitors=== | ||
Inhibitors of the [[platelet glycoprotein GPIIb-IIIa complex]] (GPIs) include the [[monoclonal antibody]] [[abciximab]] and the small-molecule agents [[tirofiban]] and [[eptifibatid]]. | Inhibitors of the [[platelet glycoprotein GPIIb-IIIa complex]] (GPIs) include the [[monoclonal antibody]] [[abciximab]] and the small-molecule agents [[tirofiban]] and [[eptifibatid]]. | ||
==Effectiveness== | ==Effectiveness== | ||
Revision as of 08:53, 13 July 2011
Platelet aggregation inhibitors, also called antiplatelet drugs, are "drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system."[1]
Classification
Adenosine diphosphate (ADP) blocker
Thienopyridines
Thienopyridines include clopidogrel, ticlopidine, and the prodrug prasugrel.[2] They inhibit the ADP receptor.
Cyclooxygenase-1 blockers
Cyclooxygenase-1 blockers include aspirin.
Thromboxane-A synthase inhibitors
This includes dipyridamole.
Glycoprotein IIb/IIIa inhibitors
Inhibitors of the platelet glycoprotein GPIIb-IIIa complex (GPIs) include the monoclonal antibody abciximab and the small-molecule agents tirofiban and eptifibatid.
Effectiveness
"The available evidence demonstrates that the use of clopidogrel plus aspirin is associated with a reduction in the risk of cardiovascular events and an increased risk of bleeding compared with aspirin alone. Only in patients with acute non-ST coronary syndrome benefits outweigh harms" according to the Cochrane Collaboration.[3]
Drug toxicity
Drug toxicity, specifically hemorrhage, is increased if clopidogrel is combined with aspirin.[4]
References
- ↑ Anonymous (2024), Platelet aggregation inhibitors (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Sudlow CL, Mason G, Maurice JB, Wedderburn CJ, Hankey GJ (2009). "Thienopyridine derivatives versus aspirin for preventing stroke and other serious vascular events in high vascular risk patients.". Cochrane Database Syst Rev (4): CD001246. DOI:10.1002/14651858.CD001246.pub2. PMID 19821273. Research Blogging.
- ↑ Squizzato A, Keller T, Romualdi E, Middeldorp S (2011). "Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular disease.". Cochrane Database Syst Rev 1: CD005158. DOI:10.1002/14651858.CD005158.pub3. PMID 21249668. Research Blogging.
- ↑ Shehab, Nadine; Laurence S. Sperling, Scott R. Kegler, Daniel S. Budnitz (2010-11-22). "National Estimates of Emergency Department Visits for Hemorrhage-Related Adverse Events From Clopidogrel Plus Aspirin and From Warfarin". Arch Intern Med 170 (21): 1926-1933. DOI:10.1001/archinternmed.2010.407. Retrieved on 2010-11-23. Research Blogging.