Plavix (clopidogrel)

Clinical Medications Worksheets Generic Name clopidogrel

Trade Name Plavix

Peak 3-7 days

Onset Within 24 hr

Classification antiplatelet agents Duration 5 days

Dose 75 mg tab

Route PO

Time/frequency Qd

Normal dosage range 75mg once daily

Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions Reduction of atherosclerotic events (MI, stroke, vascular death) N/A Mechanism of action and indications Nursing Implications (what to focus on) (Why med ordered) Contraindications/warnings/interactions Inhibits platelet aggregation by irreversibly inhibiting the binding Hypersensitivity, pathologic bleeding (peptic ulcer, intracranial of ATP to platelet receptors. The active metabolite of clopidogrel hemorrhage), patients at risk for bleeding (trauma, surgery, or other prevents binding of adenosine diphosphate (ADP) to its platelet pathologic conditions), history of GI bleeding/ulcer disease. receptor, impairing the ADP-mediated activation of the Common side effects glycoprotein GPIIb/IIIa complex. It is proposed that the inhibition No common side effects involves a defect in the mobilization from the storage sites of the Potential life threatening side effects: GI BLEEDING, BLEEDING, platelet granules to the outer membrane. No direct interference NEUTROPENIA, THROMBOTIC THROMBOCYTPENIC occurs with the GPIIb/IIIa receptor. As the glycoprotein GPIIb/IIIa PURPURA complex is the major receptor for fibrinogen, its impaired activation prevents fibrinogen binding to platelets and inhibits platelet aggregation. By blocking the amplification of platelet activation by released ADP, platelet aggregation induced by agonists other than ADP is also inhibited by the active metabolite of clopidogrel. Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine medicines (ask patient specifically) Monitor bleeding time during therapy. Prolonged bleeding time, Lovenox: Drugs that can affect hemostasis such as dextran, which is time- and dose-dependent, is expected platelet inhibitors, thrombin inhibitors, thrombolytic agents, or Monitor CBC with differential and platelet count periodically other anticoagulants may potentiate the risk of bleeding during therapy. Neutropenia and thrombocytopenia may rarely complications associated with the use of a low molecular weight occur. May cause ↑ serum bilirubin, hepatic enzymes, total heparin (LMWH), heparinoid, or fondaparinux. In patients cholesterol, nonprotein nitrogen (NPN), and uric acid receiving neuraxial anesthesia or spinal puncture, the risk of concentrations. developing an epidural or spinal hematoma during LMWH, Be sure to teach the patient the following about this medication heparinoid, or fondaparinux therapy may also be increased by the Avoid taking OTC medications containing aspirin or NSAIDs concomitant use of other drugs that affect coagulation. The without consulting health care professional. development of epidural and spinal hematoma can lead to longterm or permanent paralysis. ASA: Clopidogrel has been shown to potentiate the inhibition of platelet aggregation due to aspirin. Single-dose studies have not shown a prolongation of bleeding time when aspirin was added to clopidogrel; however, the risk of gastrointestinal (GI) bleeding may be increased. Nursing Process- Assessment Assessment Evaluation (Pre-administration assessment) Why would you hold or not give this med? Check after giving History and physical, assess risk for blood clots. Fever, chills, sore throat, or unusual bleeding Successful prevention of TIA, MI. or bruising occurs.