Skip to Main Content

++

INTRODUCTION

++

This chapter will be most useful after having a basic understanding of the material in Chapter 30, Blood Coagulation and Anticoagulant, Fibrinolytic, and Antiplatelet Drugs in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In particular, the reader is directed to the following table and to animations available in the online version of Goodman & Gilman’s The Pharmacological Basis of Therapeutics:

++

  • Table 30-3 Absolute and Relative Contraindications to Fibrinolytic Therapy.

  • Several animations in the online version of Goodman & Gilman’s The Pharmacological Basis of Therapeutics illustrate the mechanism of action of many anticoagulant, fibrinolytic, and antiplatelet drugs.

++

LEARNING OBJECTIVES

++

  • Know the classes of drugs that inhibit platelet function, their mechanisms of action, and their role in the prevention and treatment of acute coronary syndromes, strokes, and transient ischemic attacks.

  • Know the classes of drugs used as anticoagulants, their mechanisms of action, their indications in preventing and treating venous thromboembolism, pulmonary embolism, and strokes.

  • Know how anticoagulant drug therapy is monitored.

  • Know the mechanism of action of fibrinolytic agents, and their indications in treating ischemic stroke and myocardial infarction.

  • Know the major toxicities and contraindications of each class of drug.

++

DRUGS INCLUDED IN THIS CHAPTER

  • Abciximab (REOPRO)

  • Apixaban (ELIQUIS)

  • Argatroban (ARGATROBAN)

  • Aspirin (acetylsalicylic acid, ASA)

  • Bivalirudin (ANGIOMAX)

  • Clopidogrel (PLAVIX)

  • Dabigatran (PRADAXA)

  • Drotrecogin alfa (XIGRIS)

  • Eptifibatide (INTEGRILIN)

  • Fondaparinux (ARIXTRA)

  • Heparin

  • Low-Molecular-Weight Heparins (LMWHs; enoxaparin [LOVENOX], dalteparin [FRAGMIN], tinzaparin [INNOHEP], ardeparin [NORMIFLO], nadroparin [FRAXIPARIN])

  • Prasugrel (EFFIENT)

  • Rivaroxaban (XARELTO)

  • Ticlopidine (TICLID)

  • Tirofiban (AGGRASTAT)

  • Tissue plasminogen activator (t-PA; alteplase [ACTIVASE], reteplase [RETEVASE], tenecteplase [TNKASE])

  • Warfarin (COUMADIN)

++
Table Graphic Jump Location
MECHANISMS OF ACTION OF DRUGS COMMMONLY USED TO PREVENT OR TREAT THROMBOEMBOLISM
++

CASE 19-1

++

A 62-year-old man with a history of angina calls 911 complaining of crushing chest pain. The 911 operator sends an ambulance and instructs the patient to chew an aspirin while waiting for the ambulance to arrive.

++

  1. Why did the 911 operator have the patient take an aspirin?

    The patient’s history of angina suggests he has coronary artery disease and an elevated risk of an MI, and his symptoms of crushing chest pain indicate he ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.