Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

clopidogrel Plavix antiplatelet agents 75 mg tab PO Qd
Peak Onset Duration Normal dosage range
3-7 days Within 24 hr 5 days 75mg once daily
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Reduction of atherosclerotic events (MI, stroke, vascular death) N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Inhibits platelet aggregation by irreversibly inhibiting the binding Hypersensitivity, pathologic bleeding (peptic ulcer, intracranial
of ATP to platelet receptors. The active metabolite of clopidogrel hemorrhage), patients at risk for bleeding (trauma, surgery, or other
prevents binding of adenosine diphosphate (ADP) to its platelet pathologic conditions), history of GI bleeding/ulcer disease.
receptor, impairing the ADP-mediated activation of the Common side effects
glycoprotein GPIIb/IIIa complex. It is proposed that the inhibition No common side effects
involves a defect in the mobilization from the storage sites of the Potential life threatening side effects: GI BLEEDING, BLEEDING,
platelet granules to the outer membrane. No direct interference NEUTROPENIA, THROMBOTIC THROMBOCYTPENIC
occurs with the GPIIb/IIIa receptor. As the glycoprotein GPIIb/IIIa PURPURA
complex is the major receptor for fibrinogen, its impaired
activation prevents fibrinogen binding to platelets and inhibits
platelet aggregation. By blocking the amplification of platelet
activation by released ADP, platelet aggregation induced by
agonists other than ADP is also inhibited by the active metabolite
of clopidogrel.
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) Monitor bleeding time during therapy. Prolonged bleeding time,
Lovenox: Drugs that can affect hemostasis such as dextran, which is time- and dose-dependent, is expected
platelet inhibitors, thrombin inhibitors, thrombolytic agents, or Monitor CBC with differential and platelet count periodically
other anticoagulants may potentiate the risk of bleeding during therapy. Neutropenia and thrombocytopenia may rarely
complications associated with the use of a low molecular weight occur. May cause ↑ serum bilirubin, hepatic enzymes, total
heparin (LMWH), heparinoid, or fondaparinux. In patients cholesterol, nonprotein nitrogen (NPN), and uric acid
receiving neuraxial anesthesia or spinal puncture, the risk of concentrations.
developing an epidural or spinal hematoma during LMWH, Be sure to teach the patient the following about this medication
heparinoid, or fondaparinux therapy may also be increased by the Avoid taking OTC medications containing aspirin or NSAIDs
concomitant use of other drugs that affect coagulation. The without consulting health care professional.
development of epidural and spinal hematoma can lead to long-
term or permanent paralysis.
ASA: Clopidogrel has been shown to potentiate the inhibition of
platelet aggregation due to aspirin. Single-dose studies have not
shown a prolongation of bleeding time when aspirin was added to
clopidogrel; however, the risk of gastrointestinal (GI) bleeding
may be increased.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this med? Check after giving
History and physical, assess risk for blood clots. Fever, chills, sore throat, or unusual bleeding Successful prevention of TIA, MI.
or bruising occurs.