E:Antiplatelet Therapy- Clopidogrel of. Inhibits ADP-induced platelet-fibrinogen oi: binding 00 Indicated for preventing second atherosclerotic events g·Dose-75 mg po daily o). Very low incidence of neutropenia Lancet2004;34:331-7. KENTUCKY N Engl J Med2006;354:1706-17 College of Pharmacy
Antiplatelet Therapy - Clopidogrel • Inhibits ADP-induced platelet-fibrinogen binding • Indicated for preventing second atherosclerotic events • Dose - 75 mg po daily • Very low incidence of neutropenia Lancet 2004; 34: 331-7. N Engl J Med 2006; 354: 1706-17
a Antiplatelet Therapy-Clopidogrel 6 Do not use in Clopidol o2:. conjunction with aspirin 00 for stroke prevention membrane Increased risk of major Clopidogrel bleeding · Concern about use with CYP2C19 inhibitors Active Intestinal (PPIs; omeprazole) atelet KENTUCKY College of Pharmacy
Antiplatelet Therapy - Clopidogrel • Do not use in conjunction with aspirin for stroke prevention – Increased risk of major bleeding • Concern about use with CYP2C19 inhibitors (PPIs; omeprazole)
e Antiplatelet Therapy -Cilostazol o. Inhibits cyclic AMP(adenosine gE: monophosphate)phosphodiesterase lll- inducted platelet aggregation 当·Dose:100 mg orally two times/ day on an empty stomach ox. Metabolized extensively by CYP3A4 and CYP2C19 KENTUCKY College of Pharmacy
Antiplatelet Therapy - Cilostazol • Inhibits cyclic AMP (adenosine monophosphate) phosphodiesterase III– inducted platelet aggregation • Dose: 100 mg orally two times/day on an empty stomach • Metabolized extensively by CYP3A4 and CYP2C19
e Antiplatelet Therapy -Cilostazol o. Adverse effects: Headache, palpitation, 00 diarrhea, and dizziness; rarely thrombocytopenia or agranulocytosis 3:.. Contraindicated in patients with congestive heart failure ai. Monitoring: complete blood cell count with differential every 2 weeks for 3 months periodically thereafter KENTUCKY College of Pharmacy
Antiplatelet Therapy - Cilostazol • Adverse effects: Headache, palpitation, diarrhea, and dizziness; rarely, thrombocytopenia or agranulocytosis • Contraindicated in patients with congestive heart failure • Monitoring: complete blood cell count with differential every 2 weeks for 3 months; periodically thereafter
Eab Warfarin Prevention of second ischemic event 00 No improvement over aspirin 当2·|NR2-3 KENTUCKY College of Pharmacy
Warfarin • Prevention of second ischemic event – No improvement over aspirin • INR 2-3