New Anticoagulants and Antiplatelet Agents
New Anticoagulants and Antiplatelet Agents
Prasugrel is a thienopyridine approved for the prevention of thrombotic cardiovascular events (including stent thrombosis) in patients with unstable angina, non-ST elevation myocardial infarction or segment-elevation myocardial infarction who are to be managed with PCI.
Dosed as a once daily oral tablet, prasugrel attains a peak plasma concentration 0.5 h after dosage with a half-life of 2–15 h. Prasugrel is primarily excreted in the urine; however, current manufacturer recommendations state that dosing modifications are not necessary in patients with renal or hepatic impairment.
Reversal Agents To date, there are no available reversal agents that can be used in the event of an acute bleed in patients on prasugrel. Current guidelines state that blood products, such as fresh frozen plasma or cryoprecipitate are the primary agents of reversal.
Prasugrel should be discontinued at least 7 days before any procedure where therapeutic intervention is anticipated or planned.
Prasugrel (Effient)
Prasugrel is a thienopyridine approved for the prevention of thrombotic cardiovascular events (including stent thrombosis) in patients with unstable angina, non-ST elevation myocardial infarction or segment-elevation myocardial infarction who are to be managed with PCI.
Pharmacodynamics
Dosed as a once daily oral tablet, prasugrel attains a peak plasma concentration 0.5 h after dosage with a half-life of 2–15 h. Prasugrel is primarily excreted in the urine; however, current manufacturer recommendations state that dosing modifications are not necessary in patients with renal or hepatic impairment.
Reversal Agents To date, there are no available reversal agents that can be used in the event of an acute bleed in patients on prasugrel. Current guidelines state that blood products, such as fresh frozen plasma or cryoprecipitate are the primary agents of reversal.
Recommended withholding period before endoscopic procedures
Prasugrel should be discontinued at least 7 days before any procedure where therapeutic intervention is anticipated or planned.
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