Antiplatelets Flashcards
Action
Stop initial platelet plug
What are the names of some common antiplatelets?
Clopidgrel (Plavix)
Dipyridamole/aspirin (Aggrenox)
Aspirin
Cilostazol (Pletal)
For whom are antiplatelets preferred?
Patients with non-cardioembolic stroke
What is the indication for Clopidogrel (Plavix)?
Secondary prevention after a thrombotic stroke
Patients unable to take Warfarin after a cardioembolic stroke
Side effects - Clopidogrel (Plavix):
Bleeding
Bruising
Rash
Itching
Drug interactions - Clopidogrel (Plavix):
Omeprazole Lansoprazole Dexlansoprazole Esomprazole *other anticoagulants*
What is are indications for Dipyridamole/aspirin (Aggrenox)?
Secondary prevention after a thrombotic stroke
Patients who are unable to take Warfarin after a cardioembolic stroke
What is Dipyridamole/aspirin (Aggrenox)?
Timed-release –> combined c aspirin
Side effects - Dipyridamole/aspirin (Aggrenox):
Bleeding Bruising Headache Abdominal pain Diarrhea Heartburn Nausea Tinnitus
Drug interactions - Dipyridamole/aspirin (Aggrenox):
Colchicine
Keterolac
Live influenza and varicella vaccines
Anticoagulants
Contraindications - Dipyridamole/aspirin (Aggrenox):
Asthma Rhinitis Nasal polyps NSAID allergy 3rd trimester of pregnancy
Clinical considerations - Dipyridamole/aspirin (Aggrenox):
Alcohol consumption may increase GI irritation and bleeding risk
Indication for aspirin:
Started w/in 48hrs of CVA
May be used as monotherapy after a first-time thrombotic stroke
Aspirin - side effects:
GI bleeding Anemia Ringing in the ears (tinnitus) Aspirin allergy Acute toxicity
Aspirin - contraindications:
Asthma
Rhinitis
Nasal polyps
Bleeding disorders
Aspirin - clinical considerations:
DO NOT USE W/IN 24 HOURS OF ALTEPLASE
AVOID IN SEVERE RENAL OF HEPATIC IMPAIRMENT
Are baby aspirins okay to take prior to surgery?
Yes
When should anti-inflammatories be stopped prior to surgery?
48 hours before to prevent abnormal bleeding
When should aspirin be stopped prior to surgery and why?
7-10 days prior –> it permanently stops the platelets from forming clots, so need to wait for new platelets to form
What is the half-life for anti-inflammatories that needs to be taken into consideration (i.e. Stopping taking 48 hours prior to surgery)?
5 1/2 half lives
