The Sound of Evolution
Prasugrel
普拉格雷
Mechanism of action:
Prasugrel 是一種噻吩吡啶類（thienopyridine）的衍生物。Prasugrel 本身為前驅藥，必須在肝臟中經由 CYP450 酵素（主要為 CYP2C19） 代謝成活性代謝物。活性代謝物會不可逆地抑制血小板上的 P2Y₁₂ 受體（P2Y₁₂ receptor），阻斷腺苷二磷酸（ADP）與該受體的結合，抑制下游的 GPIIb/IIIa 受體活化，使血小板無法交聯纖維蛋白原（fibrinogen），進而抑制血小板聚集。
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.