Table 2.
Medications that Target the Clotting Cascade.
| Class | Drug (s) | Mechanism | Indications |
|---|---|---|---|
| Direct Thrombin Inhibitors | Argatroban, Bivalirudin, Dabigatran, Desirudin, | Inhibits coagulation through inhibition of free and fibrin bound thrombin, clotting cascade, and platelet aggregation | Cardiovascular, Vascular; prophylaxis *NCT04406389 *NCT04445935 |
| Vitamin K Antagonists | Warfarin, Acenocoumarol | Coumarin and coumarin derivatives inhibit vitamin K epoxide reductase which inhibits the process of Vitamin K dependent clotting factor synthesis | Cardiovascular, Vascular; prophylaxis |
| Factor Xa Inhibitors | Apixaban, Betrixaban, Edoxaban, Fondaparinux, Rivaroxaban | Selective, reversible inhibitors of free and bound factor Xa inhibits platelet activation and coagulation | Cardiovascular, Vascular *NCT04406389 *NCT04416048 |
| Low Molecular Weight Heparin (LMWH) | Dalteparin, Enoxaparin, Tinzaparin, Nadroparin | Inhibits factor Xa by activating antithrombin III to prevent clotting | Cardiovascular, Vascular; prophylaxis *NCT04412304 *NCT04373707 |
| Heparin and Heparinoids |
Heparin, Danaparoid sodium | Binds to antithrombin III and prevents the conversion of prothrombin to thrombin and fibrin to fibrinogen by inactivation of coagulation factors (Xa, thrombin) | Anticoagulation *NCT04397510 |
| Glycoprotein IIb/IIIa Inhibitors | Abciximab, Eptifibatide, Tirofiban | Binds to glycoprotein IIb/IIIa receptor and blocks platelet aggregation | Cardiovascular *NCT04368377 |
| ADP Induced Aggregation Inhibitors | Cangrelor, Clopidogrel, Prasugrel, Ticagrelor, Ticlopidine | P2Y12 platelet receptor inhibitors prevent ADP-induced platelet activation and aggregation | Cardiovascular, Vascular; Surgical; prophylaxis *NCT04333407 *NCT04445623 |
| Protease-Activated Receptor (PAR-1) Antagonists | Vorapaxar | Reversible PAR-1 inhibitor blocks thrombin and thrombin receptor agonist peptide platelet aggregation | Cardiovascular, Vascular; prophylaxis |
| Tissue Plasminogen Activators (TPA) | Alteplase, Reteplase, Streptokinase, Tenecteplase, Urokinase, Defibrotide | Converts plasminogen to plasmin which cleaves fibrin clots | Cardiovascular; Vascular *NCT04357730 *NCT04348383 |
| Activated Protein C | Ceprotin | Reduces thrombin formation through the inactivation of factor Va and factor VIIIa and inhibits PAF-1 | Vascular; prophylaxiss |
| Kallikrein Inhibitor | Lanadelumab | Binds kallikrein to reduce bradykinin production | Fluid Regulation *NCT04422509 |
DVT, deep venous thrombosis. Common pharmaceutical suffixes can be decoded as follows: -an, antagonist; -ib, inhibitor; –mab, monoclonal antibody *Select ClinicalTrials.gov Identifier for the testing of the highlighted listed class of drugs in COVID-19.