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Ticlopidine

Associated with TTP with and estimated incidence of 1 case per 1600 to 5000 patients treated.

Ticlopidine may increase the risk of acquired TTP by 200-300 fold.

Prevents platelet aggregation by inhibiting ADP mediated platelet activation.

Principal use short-term use after intracoronary stent deployment.

In unstable angina results in a 50% reduction in vascular deaths and nonfatal MI at 6 months.

Requires CBC every two weeks for three months because of 1-2% neutropenia.

Has a delayed onset of action with maximum inhibition of ADP-induced platelet aggregation several days after administration.

Adverse effects include neutropenia in 2-3% of patients, agranulocytosis and TTP.

Ticlid associated aplastic anemia may be as high as one case in every 4000 to 8000 patients exposed.

The incidence of TTP peaks after about 3 to 4 weeks of treatment, neutropenia peaks at approximately 4 to 6 weeks, aplastic anemia peaks after about 4 to 8 weeks.

It is rare to have neutropenia, TTP, or aplastic anemia after more than 3 months of therapy.

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