Plavix Clopidogrel Drug Card

NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name clopidogrel

Trade Name Plavix

Peak 3-7 days

Onset Within 24 hr

Classification antiplatelet agents Duration 5 days

Dose 75 mg

Route PO

Time/frequency daily

Normal dosage range 75mg once daily

Why is your patient getting this medication Reduction of atherosclerotic events (stroke)

For IV meds, compatibility with IV drips and/or solutions N/A

Mechanism of action and indications (Why med ordered) Inhibits platelet aggregation by irreversibly inhibiting the binding of ATP to platelet receptors. The active metabolite of clopidogrel prevents binding of adenosine diphosphate (ADP) to its platelet receptor, impairing the ADP-mediated activation of the glycoprotein GPIIb/IIIa complex. It is proposed that the inhibition involves a defect in the mobilization from the storage sites of the platelet granules to the outer membrane. No direct interference occurs with the GPIIb/IIIa receptor. As the glycoprotein GPIIb/IIIa 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 medicines (ask patient specifically) Increased bleeding risk with anise, arnica, chamomile, clove, fenugreek, feverfew, garlic, ginger, ginkgo, panax genseng, and others. ASA may increase risk of bleeding.

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, pathologic bleeding (peptic ulcer, intracranial hemorrhage), patients at risk for bleeding (trauma, surgery, or other pathologic conditions), history of GI bleeding/ulcer disease. Common side effects GI BLEEDING, BLEEDING, NEUTROPENIA, THROMBOTIC THROMBOCYTPENIC PURPURA

Nursing Process- Assessment (Pre-administration assessment) History and physical, assess risk for blood clots.

Lab value alterations caused by medicine Monitor bleeding time during therapy. Prolonged bleeding time, which is time- and dose-dependent, is expected Monitor CBC with differential and platelet count periodically during therapy. Neutropenia and thrombocytopenia may rarely occur. May cause inc. serum bilirubin, hepatic enzymes, total cholesterol, nonprotein nitrogen (NPN), and uric acid concentrations. Be sure to teach the patient the following about this medication Avoid taking OTC medications containing aspirin or NSAIDs without consulting health care professional.

Assessment Why would you hold or not give this med? Fever, chills, sore throat, or unusual bleeding or bruising occurs.

Evaluation Check after giving Successful prevention of stroke.