In this particular video, we’re gonna take a look at the antiplatelets,
the one that we listed right there in the middle, like aspirin and its other friend.
Now try and say that name to yourself. That’s a tough one, isn’t.
I wanna bring up the point that if you’re ever wondering how to pronounce a drug, simply Google it.
There’s tons of videos out there that will play the sound for you over and over again
and that’s one great tool for learning how to pronounce difficult drug names.
So how does antiplatelet work? Will they reduce?
Will they suppress the platelets from aggregating or clumping together,
that’s why they’re called antiplatelets -- they’re against platelets getting together.
Now, arterial thrombus has primarily what we’re dealing with has a real platelet core.
So if I’ve got a clot in an artery, they primarily are made of a big core of platelets.
When you go back to our video that talks about how clots are made, that will reinforce that concept for you.
So we primarily use antiplatelets for the prevention of thrombosis in arteries.
So we have people that we know are good at making clots in their arteries, we’re gonna go for an antiplatelet.
That’s kind of a difference in the other medication we’ve talked about.
Let’s do a quick review about what we talked about or talked about thrombi happen.
Platelets form a plug because they stick to the cut edges of the vessel,
so when those vessels have been damaged, the platelets begin to stick to that area of damage.
Now when those platelets stick to the area, then they start releasing these chemicals
that attract even more platelets, that’s what stops the bleeding.
So antiplatelets are against that action because aspirin suppress or they block or they inhibit,
they slow down platelet aggregation or clumping.
So that’s the goal of aspirin, it’s gonna stop those platelets grouping together or clumping together
because it inhibits the isoenzyme, COX.
Now, it’s also said cyclooxygenase, that’s why we say COX inhibitors instead of saying cyclooxygenase inhibitors.
So when you inhibit this isoenzyme, COX, it leads to pain relief, reduction of inflammation,
reduction of fever, and clots -- that’s our goal with antiplatelet therapy, we use it for all those ways to benefit our patients.
Before we go on the next slide, make sure you underline cyclooxygenase and the three letters,
COX, so you remember what those words mean.
You’ll see that come up a lot in pharmacology literature.
The reason your patient will experiences that antiplatelet effect for 7 to 10 days, it’s because that matches the life of the platelet.
So for thrombosis or clots, aspirin is usually used to prevent clots that form in arteries.
Right, we use other drugs for veins, but we use aspirin for clots that form in arteries.
So some of the therapeutic uses of aspirin, myocardial infarction because remember, that’s in the coronary arteries.
We also use it for chest pain; we try to use that for prevention and for acute treatment.
Now, another area clots are problematic is in your brain,
so we can use aspirin to treat ischemic stroke and transient ischemic attack or TIAs.
Those are like little mini strokes but they resolve themselves.
Okay, now this drug.
It’s really a good drug in fact my dad was on it after he had a stroke, but I hate trying to pronounce it.
This is one of those drugs when you look up on the internet will have several different types of pronunciations,
but we’re gonna go with clopidogrel, okay?
That’s what we’re going with.
It’s a pro drug that means it has to be turned into something else in order to be used in your body,
so it’s gotta be metabolized in the liver to become its active form.
Once its metabolized in the liver then it can do its job of impacting platelets
from clumping so this drug suppresses the platelet clumping by blocking,
there’s that really long name again, P2Y12ADP receptors on the platelets.
Remember, this is a great drug for antiplatelets.
Some people that have this genetic liver deficiency of these specific enzymes might have a little bit different response to that,
that’s nice to know but know that anytime someone has a liver problem it could mess with their ability to clot or to not clot.
So what do we use this for? This is great for keeping coronary stents open.
If a patient has a stent, remember that’s a -- they take a little piece of metal mesh,
they slide it in through those coronary arteries, they open up the vessels
and they leave that metal mesh there to keep it open, this medication will help them keep that open long after the procedure.
It will also help people, like my dad, who had a stroke, so we know that was likely caused by a clot,
so he was on this medication immediately after the stroke.
Also works for MI’s, heart attack or somebody who has peripheral arterial disease
because antiplatelet medications are used for people who are making really good clots in there arteries.