The pharmacodynamics of antiplatelet compounds in thrombosis treatment

Expert Opin Drug Metab Toxicol. 2016 Jun;12(6):615-32. doi: 10.1080/17425255.2016.1176141. Epub 2016 Apr 26.

Abstract

Introduction: As it is importance to understand the involvement of platelets in the initiation and propagation of thrombosis, antiplatelet drugs have come to the forefront of atherothrombotic disease treatment. Dual antiplatelet therapy of aspirin plus clopidogrel has its benefits, but it also has its limitations with regard to its pharmacologic properties and adverse effects. For these reasons, within the last decade or so, the investigation of novel antiplatelet agents has prospered.

Areas covered: In this review, we discuss the unique pharmacodynamic properties of several antiplatelet drugs with their possible potential molecular of mechanisms on inhibiting platelet aggregation.

Expert opinion: Considering multiple synergetic pathways of platelet activation and their close interplay with coagulation, the current treatment strategies are not only based on platelet inhibition, they also rely on the attenuation of procoagulant activity, inhibition of thrombin generation, and enhancement of clot dissolution. Current guidelines recommend various antiplatelet agents in addition to aspirin for patients with acute coronary syndromes. The advantages of these agents, as repute mortality, may be associated with off-target effects of the drug. Hence, further studies are required to facilitate the physician's choice of the most appropriate antiplatelet agents for each patient for thrombosis treatment.

Keywords: Antiplatelets; antithrombotic; multi-targets; pharmacodynamics.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / drug therapy
  • Animals
  • Aspirin / administration & dosage
  • Aspirin / adverse effects
  • Aspirin / therapeutic use
  • Blood Platelets / drug effects
  • Blood Platelets / metabolism
  • Clopidogrel
  • Drug Design*
  • Drug Therapy, Combination
  • Humans
  • Platelet Aggregation Inhibitors / administration & dosage*
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use
  • Practice Guidelines as Topic
  • Thrombosis / drug therapy*
  • Ticlopidine / administration & dosage
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin