Ticlopidine

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Ticlopidine


Systematic (IUPAC) name
5-(2-chlorobenzyl)-4,5,6,7-tetrahydrothieno[3,2-c]pyridine
Clinical data
Trade names	Ticlid
AHFS/Drugs.com	monograph
MedlinePlus	a695036
Pregnancy cat.	B1 (AU) C (US)
Legal status	?
Routes	Oral
Pharmacokinetic data
Bioavailability	>80%
Protein binding	98%
Metabolism	Hepatic
Half-life	*12 hours (single dose)
Excretion	Renal and fecal
Identifiers
CAS number	55142-85-3^Y
ATC code	B01AC05
PubChem	CID 5472
DrugBank	DB00208
ChemSpider	5273^Y
UNII	OM90ZUW7M1^Y
KEGG	D08594^Y
ChEBI	CHEBI:9588^Y
ChEMBL	CHEMBL833^Y
Chemical data
Formula	C₁₄H₁₄Cl N S
Mol. mass	263.786 g/mol
SMILES Clc1ccccc1CN3Cc2c(scc2)CC3
InChI InChI=1S/C14H14ClNS/c15-13-4-2-1-3-11(13)9-16-7-5-14-12(10-16)6-8-17-14/h1-4,6,8H,5,7,9-10H2^Y Key:PHWBOXQYWZNQIN-UHFFFAOYSA-N^Y
Y (what is this?) (verify)

Ticlopidine (trade name Ticlid) is an antiplatelet drug in the thienopyridine family. Like the newer drug clopidogrel, it is an adenosine diphosphate (ADP) receptor inhibitor. It is used in patients in whom aspirin is not tolerated, or in whom dual antiplatelet therapy is desirable. Because it has been reported to increase the risk of thrombotic thrombocytopenic purpura (TTP) and neutropenia, its use has largely been supplanted by clopidogrel, which is thought to have a much lower hematologic risk. Its niche role as an alternative in those patients who do not tolerate clopidogrel was superseded by Ticagrelor and Prasugrel. The usual dose is 250 mg twice daily by the oral route.

Action

Inhibits platelet aggregation by altering the function of platelet membranes by blocking ADP receptors. This prevents the conformational change of glycoprotein IIb/IIIa which allows platelet binding to fibrinogen.
Prolongs bleeding time.
Decreased incidence of stroke in high-risk patients.

Contraindications

Hypersensitivity
Bleeding disorders
Active bleeding
Severe liver disease

Precautions

Risk of bleeding (trauma, surgery, history of peptic ulcer disease)
Renal or hepatic impairment
Geriatric patients (increased sensitivity)
Pregnancy, lactation, or children under 18
Neutropenia
Thrombotic thrombocytopenic purpura

Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)

Antiplatelet drugs

Glycoprotein IIb/IIIa inhibitors	Abciximab Eptifibatide Tirofiban

ADP receptor/P2Y₁₂ inhibitors	thienopyridines Clopidogrel Prasugrel Ticlopidine nucleotide/nucleoside analogs Cangrelor Elinogrel Ticagrelor

Prostaglandin analogue (PGI2)	Beraprost Iloprost Prostacyclin Treprostinil

COX inhibitors	Acetylsalicylic acid/Aspirin^# Aloxiprin Carbasalate calcium Indobufen Triflusal

Thromboxane inhibitors	thromboxane synthase inhibitors Dipyridamole (+Aspirin) Picotamide receptor antagonist Terutroban^†

Phosphodiesterase inhibitors	Cilostazol Dipyridamole Triflusal

Other	Cloricromen Ditazole

Anticoagulants

Vitamin K antagonists
(inhibit II, VII, IX, X)

Factor Xa inhibitors
(with some II inhibition)

Heparin group/ glycosaminoglycans/ (bind antithrombin)	low molecular weight heparin Bemiparin Certoparin Dalteparin Enoxaparin Nadroparin Parnaparin Reviparin Tinzaparin oligosaccharides Fondaparinux Idraparinux heparinoid Danaparoid Dermatan sulfate Sulodexide

Direct Xa inhibitors	xabans Apixaban Betrixaban Darexaban Edoxaban Otamixaban Rivaroxaban

Direct thrombin (II) inhibitors

bivalent: Hirudin
- Bivalirudin
- Desirudin
- Lepirudin
univalent: Argatroban
Dabigatran
Melagatran^‡
Ximelagatran^‡

Other

Thrombolytic drugs/
fibrinolytics

Non-medicinal

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

M: MYL

cell/phys (coag, heme, immu, gran), csfs

rbmg/mogr/tumr/hist, sysi/epon, btst

drug (B1/2/3+5+6), btst, trns

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