Coronary artery disease clopidogrel

ADP receptor inhibitors might be used in patients with coronary artery disease, in neurology, and in angiology. This chapter will mainly consider indications of ticlopidine and clopidogrel since these are the only two drugs currently available in the market. 

Clopidogrel and secondary prevention of coronary artery disease... 

Thus, clopidogrel has to be considered a safe alternative to aspirin for secondary prevention in patients with stable coronary artery disease, It should be given to all patients with coronary artery disease and who have either a contraindication or intolerance to aspirin. 

Kastrati A, von Beckerath N, Joost A, Pogatsa-Murray G, Gorchakova O, Schomig A. Loading with 600 mg clopidogrel in patients with coronary artery disease with and without chronic clopidogrel therapy. Circulation 2004 I 10 1916-1919. 

Angiolillo DJ, Fernandez-Ortiz A, Bernardo E, etal. Platelet function profiles in patients with type 2 diabetes and coronary artery disease on combined aspirin and clopidogrel treatment. Diabetes 2005 54 2430-2435. 

The standard antiplatelet regimen for patients undergoing carotid artery stenting include aspirin 325 mg a day and clopidogrel 75 mg a day for at least one week prior to the procedure. Currently, there is no role for elective use of glycoprotein Ilb-IIIa receptor antagonists. All patients should be adequately hydrated to reduce the incidence and severity of intraprocedural hypotension. Traditionally, all antihypertensive medications are withheld on the day of the procedure. This is done to avoid excessive hypotension after CAS, particularly in patients with known severe coronary artery disease or critical aortic stenosis. 

The nurse is preparing to administer clopidogrel bisulfate (Plavix), an antiplatelet medication, to the client with coronary artery disease. The client asks the nurse, Why am I getting this medication Which statement by the nurse would be most appropriate ... 

Another example is the synthesis of rac-clopidogrel (Plavix ) 430 that is used as antiplatelet agent to inhibit the formation of blood clots in coronary artery disease (Scheme 6.65) [132]. Ross and coworkers have used a three-component Ugi reaction from commercially available starting materials (425-427) to construct intermediate 428 [133]. 

In patients with coronary artery disease who took part in a double-blind comparison of atorvastatin 20-80 mg/day ( = 22) and rosuvastatin 10-40 mg/day ( = 24), the platelet inhibitory effects of clopidogrel were not altered [176 ]. 

Problem 5.16 Draw both enantiomers of clopidogrel (trade name Plavix), a drug given to prevent the formation of blood clots in persons who have a history of stroke or coronary artery disease. Plavix is sold as a single enantiomer with the S configuration. Which enantiomer is Plavix ... 

Platelet inhibitors are widely used in the treatment and prevention of coronary artery disease. In addition to acetic salicylic acid (ASA), two major groups of platelet inhibitors are used phosphodiesterase inhibitors, including dipyridamole, and thienopyridines. Clopidogrel is the most widely used antiplatelet agent and in combination with ASA, it is the standard-of-care (SoC) for acute coronary s5mdromes and percutaneous coronary interventions. However, the mechanisms of action include pathways that affect the metabolic activity of bone cells and pharmacologic modulation of these pathways may have adverse effects on the bones. 

Clopidogrel is a dmg also known under the trade name Plavix and marketed by Bristol-Myers Squibb (New York, NY) and Sanofi-Aventis (Bridgewater, NJ). Clopidogrel is used in the treatment of coronary artery disease, polpheral vascular disease, and cerebrovascular disease. In 2009, the synthesis of methyl (Zi)-o-chloromandelate (/ )-154) (Scheme 30.29), a key intermediate to (5)-clopidogrel, was described... 

Ticlopidine and clopidogrel are thienopyridines, which through inhibition of platelet aggregation prolong bleeding time and delay clot retraction. The thienopyridines are prescribed for reduction of myocardial infarction and stroke, for treatment of peripheral arterial disease, and in combination with aspirin for acute coronary syndromes. This latter utility appears to result from the fact that both aspirin and the thienopyridines block major amplification pathways, leading to platelet aggregation... 

---