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Antithrombotic and antiplatelet therapy 

Antithrombotic and antiplatelet therapy
Antithrombotic and antiplatelet therapy

David Royston

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date: 19 October 2020

This chapter is focused on the agents used to provide prophylaxis and treatment of thrombotic complications. There is a short discussion of the process of haemostasis and clot formation prior to introducing the various pharmacological interventions. In addition to the heparins and vitamin K antagonists, the pharmacology and indications for use of novel pentasaccharides, oral direct thrombin, and Factor Xa antagonists is discussed, as are drugs used to inhibit platelet activation and adherence (including acetyl salicylic acid and dipyridamole). The majority of this chapter is devoted to agents that have been specifically targeted at platelet surface receptors. These agents include the glycoprotein IIb/IIIa and purinergic (ADP) P2Y12 antagonists. In this latter group there is detailed discussion of the pharmacology of older and more novel thienopyridine, prasugrel. Also discussed in more detail are the pharmacology and indications for using the new orally active agent ticagrelor and the short-acting intravenous ADP analogue cangrelor.

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