ANTI-PLATELET DRUGS Presented by: Laxmi

Thapa

Also called antiagreggant.Member of a class of pharmaceuticals that decrease platelet aggregation and inhibit thrombus formation.They are effective in arterial circulation.

MECHANISM OF ACTIONIt have a ability to suppress the production of prostaglandins and thromboxane is due to its irreversible inactivation of the cyclooxygenase (Cox) enzymes. Cyclooxygenase is required for prostaglandins and thromboxane synthesis.Antiplatelet therapy with one or more of these drugs decrease the ability of blood clot to form by interfering with platelet activation process in primary hemostasis.Antiplatelet drugs can reversibly or irreversibly inhibit process involved in platelet activation resulting in decreased tendency of platelet to adhere to one another and to damaged blood vessels endothelium.

CLASSIFICATION1. Irreversible cyclooxygenase inhibitorsAspirinTriflusal (Disgren)2. Adenosine diphosphate (ADP) receptor inhinitorsClopidogrel (Plavix)Prasugrel (effient)Ticagrelor (Brilinta)Ticlopidine (Ticlid)

3. Protease-activated receptor-1 (PAR-1) antagonistVorapaxar (Zontivity)4. Glycoprotein II B/ III A inhibitor (IV only)Abciximab (Reopro)Tirofiban (Aggrastat)5. Adenosine reuptake inhibitorsDipyridamole (persantine)

6. Thromboxane inhibitorsThromboxane synthase inhibitorsThromboxane receptor antagonistterutroban

INDICATIONPrimary prevention of CVDSecondary prevention of CVDAcute ischaemic eventsMyocardial ischaemiaCerebral ischaemiaAtrial fibrillationAngina (chest pain)Peripheral artery disease

ALSO USED:1. After angioplasty and stent placement2. After heart bypass or valve replacement3. To prevent the formation of blood clots in people with artrial

fibrillation.

CONTRA-INDICATIONWho are high risk of bleeding i.e. active peptic ulcer diseaseUncontrolled hypertensionHypersensitivity and allergyasthma

SIDE EFFECTSNausea/ vomitingUpset stomachStomach painDiarrheaRashesItchingSwelling of face and handsFever, chills and sore throat