DRUG CLASSIFICATION MECHANISM INDICATIONS SIDE EFFECTS AND DRUG NURSING

OF ACTION ADVERSE EFFECTS INTERACTIONS CONSIDERATION

clopidogrel PO Recent MI, Frequent (15%): Skin DRUG: Aspirin, Obtain baseline
kloe-pid-oh-grel • Give without Stroke, PAD disorders. Occasional NSAIDs (e.g., chemistries, platelet
Apo-Clopidogrel regard to food. PO: ADULTS, (8%–6%): Upper ibuprofen, count, PFA. Perform
Plavix • Avoid ELDERLY: 75 mg respiratory tract ketorolac, platelet counts before
CLASSIFICATION grapefruit once daily. infection, chest pain, naproxen), drug therapy, q2days
PHARMACOTHERAPEUTIC: products Acute Coronary flu-like symptoms, warfarin during first wk of
Thienopyridine derivative. Syndrome (ACS), headache, dizziness, may increase treatment, and wkly
CLINICAL: Antiplatelet. Unstable arthralgia. Rare risk of bleeding. thereafter until
Angina/NSTEMI (5%–3%): Fatigue, Proton pump therapeutic
PO: ADULTS, edema, hypertension, inhibitors (e.g., maintenance dose is
ELDERLY: abdominal pain, omeprazole, reached. Abrupt
Initially, loading dyspepsia, diarrhea, pantoprazole) discontinuation of drug
dose of 300–600 nausea, epistaxis, may decrease therapy
mg, then 75 mg dyspnea, rhinitis. efficacy, produces elevated
once daily (in increase risk of platelet count within 5
combination Agranulocytosis, cardiovascular days.
with aspirin for aplastic events. Intervention/evaluation
up to 12 anemia/pancytopenia Monitor platelet count
months, then , thrombotic for evidence of
aspirin thrombocytopenic thrombocytopenia.
indefinitely). purpura (TTP) occur Assess Hgb, Hct, for
ACS (STEMI) rarely. Hepatitis, evidence of bleeding;
Note: Continue hypersensitivity serum ALT, AST,
for at least 14 reaction, bilirubin, BUN,
days up to 12 anaphylactoid creatinine;
months. reaction have been signs/symptoms of
PO: ADULTS, reported hepatic insufficiency
ELDERLY 75 YRS during therapy.
OR YOUNGER: Patient/family teaching
Initially 300-mg • It may take longer to
loading stop bleeding during
dose, then 75 drug therapy.
mg once daily. • Report any unusual
ELDERLY OLDER bleeding.
THAN 75 YRS: 75 • Inform physicians,
mg once dentists if clopidogrel is
daily. being taken, esp.
ACS (PCI) before surgery is
PO: ADULTS, scheduled or before
ELDERLY: taking any new drug.
Initially, 600 mg,
then 75 mg once
daily (in
combination
with aspirin) for
at least 12
months.