Antiplatelet

Antiplatelet

Antiplatelet drugs are a class of pharmaceuticals that decrease platelet aggregation and inhibit thrombus formation. They are effective in the arterial circulation, where anticoagulants have little effect. Antiplatelet drugs are commonly used in the prevention and treatment of cardiovascular diseases, such as myocardial infarction and stroke.

Mechanism of Action

Antiplatelet drugs work by interfering with the platelet activation and aggregation process. Platelets play a crucial role in hemostasis, and their aggregation is a key step in the formation of a thrombus. The main mechanisms by which antiplatelet drugs act include:

• Inhibition of Cyclooxygenase (COX): Drugs like aspirin inhibit the enzyme cyclooxygenase, which is necessary for the synthesis of thromboxane A2, a potent promoter of platelet aggregation.

• ADP Receptor Inhibitors: Drugs such as clopidogrel and ticagrelor block the P2Y12 component of the ADP receptor on the platelet surface, preventing ADP-mediated activation of the glycoprotein GPIIb/IIIa complex, which is essential for platelet aggregation.

• Glycoprotein IIb/IIIa Inhibitors: These drugs, including abciximab, directly inhibit the GPIIb/IIIa receptor on platelets, preventing fibrinogen binding and cross-linking of platelets.

Clinical Uses

Antiplatelet drugs are primarily used in the following clinical scenarios:

• Acute Coronary Syndrome (ACS): Antiplatelet therapy is a cornerstone in the management of ACS, including unstable angina and myocardial infarction.

• Secondary Prevention of Cardiovascular Events: Patients with a history of myocardial infarction, ischemic stroke, or established peripheral arterial disease benefit from long-term antiplatelet therapy to prevent recurrent events.

• Percutaneous Coronary Intervention (PCI): Antiplatelet drugs are used to prevent thrombotic complications following PCI, including stent thrombosis.

Side Effects

The most common side effect of antiplatelet drugs is an increased risk of bleeding. Other side effects may include gastrointestinal upset, particularly with aspirin, and hypersensitivity reactions.

Contraindications

Antiplatelet drugs are contraindicated in patients with active bleeding, severe bleeding disorders, or known hypersensitivity to the drug. Caution is advised in patients with a history of peptic ulcer disease or other conditions that increase bleeding risk.

Also see

• Anticoagulant
• Thrombolytic therapy
• Cardiovascular disease
• Stroke prevention

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