Anti-platelet agents

Question 1

Example

Answer 1

Clopidogrel

Question 2

Indications

Answer 2

1. ACS

2. To prevent occlusion of stents

Question 3

Mechanism of action

Answer 3

Prevents platelet aggregation and reduces risk of arterial occlusion by binding irreversibly to adenosine diphosphate receptors (P2Y)

Question 4

Adverse effects

Answer 4

Bleeding

GIupset

Question 5

Warnings

Answer 5

Should no be prescribed in active bleeding, may need to be stopped 7 days before elective surgery. Should be used in caution in patients with renal and hepatic impairment.

Question 6

Interactions

Answer 6

Clopidogrel is a prog-drug that requires metabolism by P450 enzymes.

P450 inhibitors include omeprazole, ciprofloxacin, erythromycin

Question 7

Prescribing

Answer 7

Only available as an oral preparation. Low doses of clopidogrel require up to one week to reach their full antiplatelet effect - prescribe a loading dose (300mg) then maintenance dose of 75mg

Question 8

Communication

Answer 8

Advise patients that the purpose of treatment is to reduce the risk of heart attacks or strokes and to prolong life.