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Ferric Chloride-induced Murine Thrombosis Models
Published on: September 5, 2016
Metabolic differences of current thienopyridine antiplatelet agents
Jawed Fareed1, Walter Jeske, Indermohan Thethi
1Loyola University Chicago, Department of Pathology and Pharmacology, 2160 S. First Avenue, Maywood, Illinois 60153, USA. jfareed@lumc.edu
Expert Opinion on Drug Metabolism & Toxicology
|January 8, 2013
Summary
Thienopyridines like clopidogrel and prasugrel are vital antithrombotics. Their efficacy and safety depend on individual metabolism, drug interactions, and pharmacogenomics, influencing treatment outcomes.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Drug Metabolism
Background:
- Antithrombotics are widely prescribed globally.
- Thienopyridines are crucial in treating cardiovascular and cerebrovascular diseases.
- These drugs exhibit varied metabolic activation, leading to clinical and pharmacokinetic differences.
Purpose of the Study:
- To review the pharmacokinetic and pharmacodynamic profiles of ticlopidine, clopidogrel, and prasugrel.
- To discuss drug interactions and pharmacogenomic factors affecting thienopyridine therapy.
Main Methods:
- Comparative analysis of pharmacokinetic and pharmacodynamic data.
- Review of literature on drug interactions and pharmacogenomics related to thienopyridines.
Main Results:
- P2Y(12)-ADP receptor antagonism effectively prevents thrombosis.
- Metabolic activation, cytochrome pathways, drug interactions, and pharmacogenomics influence thienopyridine effectiveness.
- Clopidogrel has the broadest indications; prasugrel shows efficacy but carries a higher bleeding risk.
Conclusions:
- Individual patient factors significantly impact thienopyridine therapy outcomes.
- Careful consideration of metabolism, interactions, and genetics is essential for optimal use.
- Prasugrel requires judicious application due to its increased bleeding potential compared to clopidogrel.
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