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Simvastatin
Simvastatin, 2,2-dimethyl butanoic acid,
1,2,3,7,8,8a-hexahydro-3,7-dimethyl-8-[2-(tetrahydro-4hydroxy-6-oxo-2-pyran-2-yl)ethyl]-1-naphthalenyl ester
(Zocor), is an analog of lovastatin. These two drugs have
many similar properties. Both drugs, in the prodrug form,
reach the liver unchanged after oral administration, where
they undergo extensive metabolism to several open-ring hydroxy
acids, including the active _-hydroxy acids. They are
also highly bound to plasma proteins. These actions make
the bioavailability of simvastatin rather poor but better than
that of lovastatin, which has been estimated to be 5%.
Clopidogrel.
Clopidogrel, methyl ()-(S)--(2- chlorophenyl)-6,7-dihydrothieno[3,2c]pyridine-5(4H)- acetate sulfate (Plavix), is useful for the preventative
management of secondary ischemic events, including myocardial infarction,
stroke, and vascular deaths . It may be classified as a thienopyridine because
of its heterocyclic system. Several agents possessing this system have been
evaluated as potential antithrombotic agents. These agents have a unique
mechanism, in that they inhibit the purinergic receptor located on platelets.
Normally, nucleotides act as agonists on these receptors, which include the
P2Y type. Two P2Y receptor subtypes (P2Y1 and P2Y2) found on platelets,
when stimulated by adenosine diphosphate (ADP), cause platelet
aggregation. Clopidogrel acts as an antagonist to the P2Y2 receptor.
Lisinopril.
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