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Acute Coronary Syndrome: Oral P2Y12 Inhibitors - #MEDSHED

Updated: Apr 8

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💟 ACS: Oral P2Y12 Inhibitors - #MEDSHED



💊 P2Y12 inhibitors are a part of standard therapy pre-PCI. They're general mechanism is to inhibit the P2Y12 receptor on platelets, resulting in a reduction in platelet aggregation.



📭 Three oral agents that are utilized include clopidogrel, ticagrelor, and prasugrel. Clopidogrel has been the most historically used as ticagrelor and prasugrel are newer agents. The more novel P2Y12 inhibitors provide favorable pharmacokinetics compared to clopidogrel.



🌐 However, there are several considerations to keep in mind when selecting specific agents per patient parameters. Clopidogrel has a slow onset of action compared to the other agents and extensively metabolized by CYP2C19. Ticagrelor has been associated with therapy discontinuation due to dypsnea and bradyarrhythmias. With prasugrel, be mindful that it is contraindicated in patient's with a history of stroke or TIA secondary to increased risk of bleeding.



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