Neurosurgery notes/Pharmacology/Anti-platelet-coagulation

Anti-platelet-coagulation

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Parent item
Pharmacology
Sub-item
Anticoagulants and antiplatelet
Coagulation cascade
Haemostatic agents neurosurgery
Types of bleeding
Coagulation methods
Tranexamic acid (TXA)
Protamine
Major haemorrhage
Thromboelastography (TEG)
Blood products
DVT prophylaxis
  • Antiplatelets - all work by ↓ platelet aggregation
      • Drug
      Mechanism
      Clinical use
      Adverse effects
      Aspirin
      Irreversibly blocks COX → ↓ TXA₂ release
      Acute coronary syndrome; coronary stenting; ↓ incidence or recurrence of thrombotic stroke
      Gastric ulcers, tinnitus, allergic reactions, renal injury, Reye syndrome (in children)
      Clopidogrel, prasugrel, ticagrelor
      Block ADP (P2Y₁₂) receptor → ↓ ADP-induced expression of GpIIb/IIIa
      Same as aspirin; dual antiplatelet therapy
      Bleeding
      Eptifibatide, tirofiban
      Block GpIIb/IIIa (fibrinogen receptor) on activated platelets
      Unstable angina, percutaneous coronary intervention
      Bleeding, thrombocytopenia
      Cilostazol, dipyridamole
      Block phosphodiesterase → ↓ cAMP hydrolysis → ↑ cAMP in platelets
      Intermittent claudication, stroke prevention, cardiac stress testing, prevention of coronary stent restenosis
      Nausea, headache, facial flushing, hypotension, abdominal pain