Antiplatelet treatment

Aspirin -AKA acetylsalicylic acid Non -selective cyclooxygenase inhibitor ( inhibits thromboxane A2 -this has role in the complications of the atheromatosis lesions ) It binds to and acetylates serine residues in cyclooxygenases leading to ○ decreased synthesis of prostaglandin , platelet aggregation and inflammation Another mechanism has been described : the induction of production of aspirin-triggered lipoxins ( ATLs ) It is believed that ATL resolves inflammation and acts as antioxidant & immunomodulator Aspirin has analgesic , antipyretic and anticoagulant properties It does not alter coagulation tests TXA2 inhibition is irreversible ie the effect persists for the lifespan of the thrombocyte ie 7-10 days Extends bleeding time

THIENOPRIDINE DERIVATIVES Clopidogrel , prasugrel and ticagrelor are thienopyridine derivatives Block binding of ADP to its platelet receptor ( ADP is powerful inducer of platelet aggregation ) Interfere with ADP mediated activation of glycoprotein IIb-IIIa complex Irreversibly inhibit platelet aggregation No effect on prostaglandin metabolism Do not affect coagulation profile( ie PT and PTT monitoring is not required )

DIPYRIDAMOLE - synthetic derivative of pyrimido-pyrimidine with anti-platelet properties inhibits the uptake of adenosine into erythrocytes , platelets and endothelial cell -increased adenosine conc locally to act on platelet A2 receptors which stimulates platelet...