Investigation into the effect of prasugrel versus clopidogrel on platelet thromboelastography (TEG) analysis in paediatric patients on Ventricular Assistance Devices (VAD)

Conclusions The response seen in our patients to prasugrel is similar to studies conducted in adults where prasugrel achieves a greater ADP inhibition than clopidogrel.2 Additionally the time take to achieve effective ADP inhibition was faster. One of the possible causes of this is likely to be due to the different expression of metabolising enzymes in individual patients as both drugs are metabolised in vivo to form their active substrates.3 As prasugrel gives more effective ADP inhibition than clopidogrel, the risk of bleeding events will also be higher. This has been observed in adult clinical trials.2 The intra- and inter-patient variation in TEG response observed supports routine monitoring using TEG analysis to guide dosing and manage side effects such as bleeding. Effective anticoagulation is imperative to prevent complications on VAD including cerebrovascular accidents that occur in about 30% of patients.4 The management of these patients highlights the importance of prescribers to have access to high quality medicines information to guide dosing, avoid interactions and ensure therapy is optimised.
Source: Archives of Disease in Childhood - Category: Pediatrics Authors: Tags: Drugs: cardiovascular system, Stroke Abstracts from the Poster and Oral presentations from the 18th Neonatal and Paediatric Pharmacists Group (NPPG) Annual Conference held at the Liverpool Marriott Hotel from 9-11 November 2012 Source Type: research