platelet mechanism and clopidogrel metabolism

1. Myelotoxicity of Thienopyridines

3. Platelet aggregation mechanism

6. Thienopyridines Ticlopidine (1 st generation) N F O S O O C H 3 Clopidogrel (2 nd generation) Prasugrel (CS-747) (LY640315) (3 rd generation) N S Cl N S Cl COOCH 3

8. Mode of Action of Clopidogrel COX (cyclo-oxygenase) ADP (adenosine diphosphate) TXA 2 (thromboxane A 2 ) Jarvis B, Simpson K. Drugs 2000; 60: 347–77. CLOPIDOGREL ASA COX ADP ADP C GPllb/llla (Fibrinogen receptor) Collagen thrombin TXA 2 Activation TXA 2

10. Activation of clopidogrel

11. Activation of clopidogrel