anti-platelets

Aspirin

Low dose: irreversibly blocks COX1 <only>

Anti-platelet (75-325 mg/day)

Standard dose: irreversibly blocks COX 1 & 2

Analgesic, antipyretic (325 - 650mg q6h)

Anti-inflammatory (3 - 5 g/day)

Dipyridamole

coronary vasodilator and a relatively weak antiplatelet drug

combined with aspirin

MOA: block platelet uptake of adenosine

(+) adenosine A2 receptor → ↑ cAMP → ↓ Ca2+

Cilostazol

antiplatelet + vasodilator

MOA: inhibits PDE3 → decrease degradation of cAMP

Result: ↑ cAMP = ↓ Ca²+

Adenosine Diphosphate (ADP) Inhibitors

MOA: block platelet ADP P2 Y12 receptors

Result: decrease GP2b/ 3a receptor activation → no platelet-platelet aggregation

ADP Irreversible blockers

Clopidogrel
Prasugrel

Reversible Blockers

Ticagrelor

Cangrelor

Glycoprotein-2b/3a Antagonists

MOA: block GP 2b/3a receptor (director)

Result: decrease cross-linking of platelets by fibrinogen

Abciximab

Tirofiban

Eptifibatide

Abciximab

first platelet GP-2b/3a antagonist to be developed

Tirofiban

derivative of tyrosine

Eptifibatide

cyclic heptapeptide from rattlesnake venom

Vorapaxar

protease-activated receptor-1 (PAR-1) antagonist

approved for patients with a history of MI

Aspirin: uses

Prevent MI

Prevent 2nd MI

Dipyridamole: Uses

vasodilator during myocardial perfusion imaging (Thallium imaging)

stroke prevention

Cilostazol: Uses

treatment of intermittent claudication (pain & weakness of limb)