Platelets are blood cells that are help the blood clot (stick together) and prevent bleeding. When the body has a cut, scratch, bruise or bleed, platelets go into action and begin to work. An antiplatelet, also called an antiplatelet agent, prevents clotting, and is something you should consider if you are at risk for stroke.
What are antiplatelet agents?
Antiplatelet agents are medications that block the formation of blood clots by preventing the clumping of platelets.
There are three types of antiplatelet agents:
1. aspirin
2. thienopyridines
3. glycoprotein IIb/IIIa inhibitors
Is one type better than another? Well that depends on what you need. So, how do they differ?
These three different agents differ in four ways:
1. the way in which they prevent platelets from clumping
2. their potency (how strongly they prevent clumping)
3. how rapidly they work
4. their cost
Let’s take a look at how these three different antiplatelet agents work?
1. Aspirin: Aspirin is a great antiplatelet as it prevents blood from clotting by blocking the production of thromboxane A-2, a chemical that platelets produce that causes them to clump. So, how does it block the production? Aspirin does this by inhibiting the enzyme that produces thromboxane A-2. There are other antiplatelets that do the same thing, but Asprin is the best antiplatelet agent of this type because its inhibition of the enzyme lasts much longer than the others do.
There are many uses for aspirin such as to help relieve pain, fever and inflammation. However, using Aspirin as an antiplatelet is best for patients who have had a TIA or stroke, as it is used to reduce the risk of having another TIA or stroke. It may mean that when you get a cut it does not heal as fast, but it thins the blood just enough to help prevent another TIA or stroke. Aspirin can irritate the stomach, so take it with a full glass of water, milk, or food to help decrease stomach problems.
Because you can buy Asprin over the counter, you do not need a prescription for this type of antiplatelet. However, unless recommended by your doctor, you should not use Asprin as an antiplatelet as you may thin your blood more than is healthy for your body, and cuts and bruises will take too long to heal. So use it carefully and with doctor suggestion.
2. Thienopyridines: Platelets also produce ADP. When ADP attaches to receptors on the surface of platelets, the platelets clump. So,thienopyridines, job is to block the ADP receptors. Blocking the ADP receptor prevents ADP from attaching to the receptor and the platelets from clumping.
Brands of this type of thienopyridines include:
Ticlopidine
Clopidogrel, generic name, Brand Name Plavix
This type of antiplatelet is best used when prescribed by a doctor, it is helpful to prevent future strokes, but there can be some complications. If you use the antiplatelet ticlopidine you will have to have blood work done every couple of weeks for about three months to make sure that you are not preventing too much clotting.
3. Glycoprotein IIB/IIa Inhibitors. The glycoprotein IIb/IIIa inhibitors prevent clumping of platelets by inhibiting a different receptor on the surface of platelets, the receptor for glycoprotein IIb/IIIa. The glycoprotein IIb/IIIa inhibitors that are approved by the FDA, but must be given intravenously.
Brands include:
Abciximab, the generic drug, Name brand Reopro
Eptifibatide, the generic drug, Name brand Integrilin
Because this form of antiplatelet must be taken intravaneously your doctor must give you a prescription for this. You may have to get this medication at the hospital, or in a lab.