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Adenosine
receptor A2a
Adenosine
receptor A2b
Adenylate
Cyclase
Adenosine
transporter
cAMP-specific
3',5'-cyclic
phosphodiesterase
4D
Adenosine
deaminase
Prostacyclin
receptor
Multidrug
resistance-
associated
protein 4
Multidrug
resistance-
associated
protein 4
Prostacyclin
transporter
Prostaglandin
G/H synthase 1
Prostaglandin
G/H synthase 2
Thromboxane-A
synthase
Adenosine
Dipyridamole
Dipyridamole
Prostaglandin I2
Prostaglandin I2
Adenosine
Dipyridamole
Dipyridamole
Dipyridamole
Dipyridamole
ATP
cAMP
AMP
H
2
O
Inosine
NH
3
Arachidonic acid
Prostaglandin H2
Thromboxane A2
Magnesium
Zinc (II) ion
Zinc (II) ion
Prostacyclin
Synthesis
Platelet activation and
aggregation
Platelet
Dipyridamole is transported
into the platelet cell via
multidrug
resistance-associated
protein 4
Dipyridamole inhibits the
adenosine transporter,
preventing re-uptake of
adenosine from the
extracellular space into the
cytosol.
Dipyridamole inhibits
adenosine deaminase which is
responsible for adenosine
breakdown
The concentration of
adenosine is high in the
extracellular space, leading
to increased activation of
the adenosine receptors
Activation of adenosine
receptors activates the Gs
signaling cascade which
results in increased cAMP
porduction. cAMP inhibits
platelet activation and
aggregation and prevents the
release of arachidonic acid
from membrane phospholipids
Reduced production of
thromboxane, which is
responsible for platelet
activation and aggregation.
Endothelial Cell
Dipyridamole increases
prostacyclin synthesis.
More prostacyclin produced.
The prostacyclin is
transported out of the
endothelial cell and acts of
prostacyclin receptors on
platelets which activates
adenylate cyclase.
Cytosol
Cytosol
Extracellular Space
ADORA2A
ADORA2B
ADCY10
SLC29A1
PDE4D
ADA
PTGIR
ABCC4
ABCC4
Unknown
PTGS1
PTGS2
TBXAS1
Adenosine
Dipyridamole
Dipyridamole
Prostaglandin
I2
Prostaglandin
I2
Adenosine
Dipyridamole
Dipyridamole
Dipyridamole
Dipyridamole
Adenosine
triphosphate
cAMP
Adenosine
monophosphate
Water
Inosine
Ammonia
Arachidonic
acid
Prostaglandin
H2
Thromboxane A2
Prostacyclin
Synthesis