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Antiplatelets (Indications (Aspirin
Acute MI
Secondary prevention of MI,…
Antiplatelets
Indications
Aspirin
Acute MI
Secondary prevention of MI, stroke, TIA
Stable angina
PCI/CABG
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Overall
Primary prevention of ACS/stroke in high risk patients
Secondary prevention of ACS/stroke in patients with angina, ACS, PVD, AF, MI, stroke, TIA
Prevention of ACS/stroke during PCI
Clopidogrel
Monotherapy: aspirin CI
Dual therapy: NSTEMI, STEMI, primary prevention AF
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MOA
Atherosclerotic plaque formation
Damage to vascular epithelium, atheromas
Platelet rich thrombi formation
Occulusion of vessels, emboli
Acute MI or stroke
MOA antiplatelets
Inhibit platelet formation in the arterial circulation
In fast flowing arterial vessels, thrombi mostly composed of platelets and little fibrin
Cardiovascular protection
Types
Thienopyridones
E.g. clopidogrel, prasugrel, ticagrelor
ADP-R inhibitors, prevent platelet acitivation and aggregation
-
Aspirin
COX inhibitor, reduced TX production
Reduces Plt coagulation at site
GP II/IIIa inhibitors
E.g. abciximab, eptifibatide, tirofiban
Block fibrinogen binding to platelet
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Interactions
Aspirin
MANY, including warfarin
Clopidogrel
Carbamazepine, fluoxetine
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