CARDIO: CLOPIDOGREL

Question 1

CLOPIDOGREL: INDICATIONS

Answer 1

• Generally prescribed with ASPIRIN, although clopidogrel may be used alone where aspirin is CI/not tolerated

=> ACS
=> Coronary Artery Stents
=> Secondary prevention of thrombotic arterial events in patients where cardiovascular, cerebrovascular and peripheral arterial dx
=> Afib (reduce thrombus risk)

Question 2

CLOPIDOGREL: MOA

Answer 2

Prevents platelet aggregation and reduces the risk of arterial occlusion by binding irreversibly to Adenosine diphosphate receptors on the surface of platelets

Question 3

CLOPIDOGREL: ADVERSE EFFECTS

Answer 3

• Bleeding
• GI upset (dyspepsia, abdominal pain, diarrhoea)
• Rarely affects platelet numbers = THROMBOCYTOPENIA

Question 4

CLOPIDOGREL: WARNINGS

Answer 4

• DO NOT prescribe to patients with active bleeding
• Needs to be stopped 7 days before elective surgery
• Use in caution with patients who have renal + hepatic impairment, esp with patients who have increased risk of bleeding

Question 5

CLOPIDOGREL: INTERACTIONS

Answer 5

• Efficacy reduced with cytochrome P450 inhibitors, inhibiting its activation
• Omeprazole, ciprofloxacin, erythromycin, some antifungals and some SSRIs
• Gastroprotection - PPI where patients are taking aspirin, and also clopidogrel (Lansoprazole, Pantoprazole)
• Co prescriptions of C with other antiplatelet drugs (heparin), or NSAIDs increase risk of bleeding