Aspirin and Clopidogrel Combination - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 02-03-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
Drug Aspirin and Clopidogrel Combination

Somebody can tell me: Why I can't use aspirin and clopidrogel in combination? what is the mechanism action if you use both together? because I had this question on my test on and I didn't know the answer.



Reply With Quote Quick reply to this message



  #2  
Old 02-03-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 226
Threads: 60
Thanked 30 Times in 24 Posts
Reputation: 40
Default

I think they can be used together , but they both work in different pathways , what was your question ????
Reply With Quote Quick reply to this message
  #3  
Old 02-03-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 270
Threads: 34
Thanked 224 Times in 119 Posts
Reputation: 234
Default

I don't know for sure what the answer it but I can try and answer it based on my knowledge. From what I know it forms a really bad combination as absolutely no platelet plugs will form.

1. Clopidogrel inhibits the first step of platelet aggregation. It IRREVERSIBLY blocks ADP induced expression of the platelet GPIIb/IIIa receptors. So platelets cannot stick together and start clot formation at all.

2. Aspirin inhibits the second step of platelet aggregation. It IRREVERSIBLY blocks COX and thus production of TXA2. No TXA2 means further platelet aggregation and sticking together cannot occur.


Since both these drugs cause IRREVERSIBLE effects and stop the steps of platelet aggregation, all the platelets in the blood will be completely non functional and will not stick together AT ALL (not even a little bit)!!!!!!!!!! Person will bleed to death!!!!!


I hope that made sense....
Reply With Quote Quick reply to this message
 
  #4  
Old 02-03-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 226
Threads: 60
Thanked 30 Times in 24 Posts
Reputation: 40
Default

Quote:
Originally Posted by haga View Post
I don't know for sure what the answer it but I can try and answer it based on my knowledge. From what I know it forms a really bad combination as absolutely no platelet plugs will form.

1. Clopidogrel inhibits the first step of platelet aggregation. It IRREVERSIBLY blocks ADP induced expression of the platelet GPIIb/IIIa receptors. So platelets cannot stick together and start clot formation at all.

2. Aspirin inhibits the second step of platelet aggregation. It IRREVERSIBLY blocks COX and thus production of TXA2. No TXA2 means further platelet aggregation and sticking together cannot occur.


Since both these drugs cause IRREVERSIBLE effects and stop the steps of platelet aggregation, all the platelets in the blood will be completely non functional and will not stick together AT ALL (not even a little bit)!!!!!!!!!! Person will bleed to death!!!!!


I hope that made sense....


that is there mechanism of action , there is nothing that prevent using 2 anticoagulant at the same time (although the risk of bleeding)
but he ask if there is specific reason why these specific 2 drugs cant be used together???
Reply With Quote Quick reply to this message
  #5  
Old 02-03-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 270
Threads: 34
Thanked 224 Times in 119 Posts
Reputation: 234
Default

cuz it would cause fatal anticoagulation....????
Reply With Quote Quick reply to this message
  #6  
Old 02-03-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
Default

I had this question on my test: A patient with stroke and his Dr decide to use ASPIRIN for 4 years,today is arrived in the clx and the Dr decide to change him to CLOPIDOGREL. The Dr cannot use both by which mechanism of action?

I don't remember the answer key
Reply With Quote Quick reply to this message
  #7  
Old 02-03-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 270
Threads: 34
Thanked 224 Times in 119 Posts
Reputation: 234
Default

well they both inhibit platelet aggregation / sticking together. Was that one of the options???
Reply With Quote Quick reply to this message
  #8  
Old 02-03-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
Default

No! everything was in the liver
Reply With Quote Quick reply to this message
  #9  
Old 02-03-2012
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 791
Threads: 76
Thanked 673 Times in 317 Posts
Reputation: 691
Default

Im not sure about the exam but in real world we do use aspirin and clopidogrel in combination.....!!!!!!! many cardiologists, neurologists use them in combo and pharma companies do market them heavily....
Reply With Quote Quick reply to this message
The above post was thanked by:
billy (09-10-2012), step_enhancer (02-03-2012)
  #10  
Old 02-03-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 270
Threads: 34
Thanked 224 Times in 119 Posts
Reputation: 234
Default

Quote:
Originally Posted by alfjof View Post
No! everything was in the liver
Then I have no clue....
Reply With Quote Quick reply to this message
  #11  
Old 02-03-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 710 Times in 380 Posts
Reputation: 720
Default

ADP causes expression of GpIIb/IIIa and links platelets via fibrinogen

CLOPIDOGREL irreversibly blocks ADP

TXA2 pormotes platelet aggregation -blocked by irreversibly by ASPIRIN

ADP and TXA2 are only weapon platelets have got ,without them platelets are impotent .

maybe pt was with liver failure or liver cirrhosis -less cloating factors production-so at a risk of Heahorrhagic disease -if u give them aspirin+clopidogrel it can cause massive heamorrhage.

or liver failure pt with portal hypertension so already at risk of bleeding .
Reply With Quote Quick reply to this message
  #12  
Old 02-03-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
Default

Now I remember one the answer of choice

Aspirin Enhance the liver metabolism by P450
Reply With Quote Quick reply to this message
  #13  
Old 02-03-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 710 Times in 380 Posts
Reputation: 720
Default

this answer choice is most likely incorrect as aspirin does not enhance cyt p450
Reply With Quote Quick reply to this message
  #14  
Old 02-03-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
Default

Quote:
Originally Posted by step_enhancer View Post
this answer choice is most likely incorrect as aspirin does not enhance cyt p450
I know,but there is no way to find the reason why both cannot use together
Reply With Quote Quick reply to this message
The above post was thanked by:
step_enhancer (02-03-2012)
  #15  
Old 02-03-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 851
Threads: 88
Thanked 710 Times in 380 Posts
Reputation: 720
Default

Quote:
Originally Posted by alfjof View Post
I know,but there is no way to find the reason why both cannot use together
when did u take the test and how was the length of the questions stems.like as compared to nbme 11 as i found it lengthy .thank a lot
Reply With Quote Quick reply to this message



  #16  
Old 02-04-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
Default

on 22nd December was something like Nbme 7 and 11
Reply With Quote Quick reply to this message



Reply

Tags
Pharmacology-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Clopidogrel & Aspirin Haisook USMLE Step 3 Forum 2 12-02-2011 04:25 PM
My step 1 Combination liquidreams USMLE Step 1 Forum 4 11-18-2010 10:34 AM
Combination question. donofitaly USMLE Step 1 Forum 4 10-06-2010 12:21 PM
Courvoisier Law and the Pain - Jaundice combination lee-usmle USMLE Step 2 CK Bits & Pieces 1 06-08-2010 03:15 PM
Kaplan + FA is the ultimate combination RRMadukha USMLE Step 2 CS Forum 0 04-24-2010 02:44 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)