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Essential pharmacology of antithrombotic agents 

Essential pharmacology of antithrombotic agents
Chapter:
Essential pharmacology of antithrombotic agents
Author(s):

Thomas Cuisset

, Stefan K. James

, Andrea Rubboli

, Lars H. Rasmussen

, Giancarlo Agnelli

, and Gregory Y. H. L Lip

DOI:
10.1093/med/9780199665952.003.0005
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date: 02 December 2020

Aspirin is a relatively weak antiplatelet agent, which acts through the irreversible inhibition of the platelet enzyme cyclo-oxygenase-1. P2Y12-receptor inhibitors, including thienoyridinesclopidogrel, and prasugrel, and cyclopentyl-triazolo-pyrimidine ticagrelor are potent oral antiplatelet agents. Among parenteral anticoagulants subcutaneous low-molecular-weight heparin enoxaparin,fondaparinux, and intravenous bivalirudineach show a superior efficacy to safety relationship. Vitamin K-antagonists act by impairing the hepatic synthesis of coagulation factors II, V, VII, and IX, and are complex to manage. Newer non vitamin K-antagonists, direct oral anticoagulants inhibit single coagulation factors (thrombin, factor Xa), and have predictable anticoagulant effects with no need for routine laboratory monitoring.

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