The Sound of Evolution
Prasugrel
Mechanism of action:
Prasugrel is a thienopyridine derivative. Prasugrel itself is a prodrug and must be metabolized in the liver by CYP450 enzymes, mainly CYP2C19, into its active metabolite. The active metabolite irreversibly inhibits the P2Y12 receptor on platelets, blocks the binding of adenosine diphosphate (ADP) to this receptor, and inhibits downstream activation of the GPIIb/IIIa receptor, thereby preventing platelets from cross-linking fibrinogen and ultimately inhibiting platelet aggregation.
Reference(s):
1. Dovlatova NL et al. (2008). The reversible P2Y antagonist cangrelor influences the ability of the active metabolites of clopidogrel and prasugrel to produce irreversible inhibition of platelet function. J Thromb Haemost.
2. Tagarakis GI et al. (2010). Ticagrelor and prasugrel: two novel, most-promising antiplatelet agents. Recent Pat Cardiovasc Drug Discov.
3. Angiolillo DJ et al. (2012). The evolution of antiplatelet therapy in the treatment of acute coronary syndromes: from aspirin to the present day. Drugs.