Cangrelor - Pharmacology
Cangrelor (Kengreal) is a parenteral analogue of adenosine triphosphate
Cangrelor binds reversibly to the platelet P2Y12 receptor → Preventing signaling & activation of platelets by ADP
Onset: 2 minutes
Offset: ~ 1 hour
T 1/2: ~3 to 6 minutes
Indications:
• Considered as adjunct to PCI in patients not adequately pre-treated with an oral P2Y12 inhibitor
No oral/enteral access
Cardiac arrest upon presentation
• Bridge therapy
- To coronary artery bypass grafting (CABG)
- As antiplatelet in those with recent DES and no enteral access
Transitioning from IV to PO Antiplatelet:
• Both prasugrel and clopidogrel, are prodrugs, requiring metabolism in order to exert therapeutic effects
- These active metabolites have short circulating durations in the blood
stream
• So, if the platelet P2Y12 receptor is already occupied by cangrelor, the effects of clopidogrel and prasugrel will not be appreciated due to rapid fall to subtherapeutic levels
• Ticagrelor binds to a site different from the ADP-binding site. Ticagrelor's half-life is between 6 and 12 hours, such that the drug is still systemically available after a cangelor infusion is stopped
#Cangrelor #Kengreal #Pharmacology
