Name of Drug

Clopidogrel 75 mg 1 tab PO OD

General Action Antiplatelet agents; Platelet aggregation inhibitors

Specific Action
Inhibits platelet aggregation by irreversibly inhibiting the binding of ATP to platelet receptors. Therapeutic Effects: Decreased occurrence of atherosclerotic events in patients at risk.

Indications
Reduction of atherosclerotic events (MI, stroke, vascular death) in patients at risk for such events including recent MI, acute coronary syndrome (unstable angina/non-Q-wave MI), stroke, or peripheral vascular disease.

Contraindications
Contraindicated in: Hypersensitivity Pathologic bleeding (peptic ulcer, intracranial hemorrhage) Lactation. Use Cautiously in: Patients at risk for bleeding (trauma, surgery, or other pathologic conditions) History of GI bleeding/ulcer disease Severe hepatic impairment

Adverse Reaction
CNS: Depression, Dizziness, Fatigue, Headache. EENT: Epistaxis. Resp: Cough, Dyspnea. CV: Chest Pain, Edema, Hypertension. GI: GI Bleeding, Abdominal Pain, Diarrhea, Dyspepsia, Gastritis. Derm: Pruritus, Purpura, Rash. Hemat: Bleeding, Neutropenia, Thrombotic Thrombocytopenic Purpura. Metab: Hypercholesterolemia. MS: Arthralgia, Back Pain. Misc: Fever, Hypersensitivity Reactions.

Nursing Responsibilities Assessment

Assess patient for symptoms of stroke, peripheral vascular disease, or MI periodically during therapy. Monitor patient for signs of thrombotic thrombocytic purpura (thrombocytopenia, microangiopathic hemolytic anemia, neurologic findings, renal dysfunction, fever). May rarely occur, even after short exposure (<2 wk). Requires prompt treatment.

Implementation
Discontinue clopidogrel 5-7 days before planned surgical procedures. PO: Administer once daily without regard to food.

Patient/Family Teaching
Instruct patient to take medication exactly as directed. Take missed doses as soon as possible unless almost time for next dose; do not double doses. Advise patient to notify health care professional promptly if fever, chills, sore throat, or unusual bleeding or bruising occurs. Advise patient to notify health care professional of medication regimen prior to treatment or surgery.