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Clopidogrel wikipedia

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    Clopidogrel wikipedia


    They are widely used in primary and secondary prevention of thrombotic cerebrovascular or cardiovascular disease. Antiplatelet therapy with one or more of these drugs decreases the ability of blood clot to form by interfering with platelet activation process in primary hemostasis. Antiplatelet drugs can reversibly or irreversibly inhibit the process involved in platelet activation resulting in decreased tendency of platelets to adhere to one another and to damaged blood vessels' endothelium. states: "...low-dose aspirin increases the risk of major bleeding 2-fold compared with placebo. However, the annual incidence of major bleeding due to low-dose aspirin is modest—only 1.3 patients per thousand higher than what is observed with placebo treatment. Treatment of approximately 800 patients with low-dose aspirin annually for cardiovascular prophylaxis will result in only 1 additional major bleeding episode." Often a combination of aspirin plus an ADP/P2Y inhibitor (such as clopidogrel, prasugrel, ticagrelor, or another) is used in order to obtain greater effectiveness than with either agent alone. This is known as "Dual antiplatelet therapy" (or DAPT). propranolol 40mg Clopidogrel Tablets belong to a group of medicines called antiplatelet medicinal products. Platelets are very small structures in the blood, which clump together during blood clotting. By preventing this clumping, antiplatelet medicinal products reduce the chances of blood clots forming (a process called thrombosis). Clopidogrel Tablets are taken to prevent blood clots (thrombi) forming in hardened blood vessels (arteries), a process known as atherothrombosis, which can lead to atherothrombotic events (such as stroke, heart attack or death). You have been prescribed Clopidogrel Tablets to help prevent blood clots and reduce the risk of these severe events because: If you think any of these apply to you, or if you are in any doubt at all, consult your doctor before taking Clopidogrel Tablets. Take special care with Clopidogrel Tablets: If any of the situations mentioned below apply to you, you should tell your doctor before taking Clopidogrel Tablets: Clopidogrel Tablets are not intended for use in children or adolescents. Taking other medicines Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

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    The reformulation of clopidogrel bisulfate is an example of the potential for Acusphere's proprietary Hydrophobic Drug Delivery System HDDSTM technology to create intravenous formulations of drugs that are currently only available in oral dosage form. xanax side effects withdrawal Ticlopidine, taken together with aspirin, is FDA approved for this purpose, and in studies it has been shown to work better than aspirin alone or aspirin with an anticoagulant. However, ticlopidine’s serious side effects make it less useful than its cousin, clopidogrel. Current recommendations no longer recommend ticlopidine’s use. Prasugrel is a member of the thienopyridine class of ADP receptor inhibitors, like ticlopidine trade name Ticlid and clopidogrel trade name Plavix. These agents reduce the aggregation "clumping" of platelets by irreversibly binding to P2Y 12 receptors.

    Ticlopidine (trade name Ticlid) is an antiplatelet drug in the thienopyridine family which is an adenosine diphosphate (ADP) receptor inhibitor. Research initially showed that it was useful for preventing strokes and coronary stent occlusions. However, because of its rare but serious side effects of neutropenia and thrombotic thrombocytopenic purpura it was primarily used in patients in whom aspirin was not tolerated, or in whom dual antiplatelet therapy was desirable. With the advent of newer and safer antiplatelet drugs such as clopidogrel and ticagrelor, its use remained limited. Ticlopidine was discovered in the 1970s in France by a team led by Fernand Eloy and including Jean-Pierre Maffrand at Castaigne SA that was trying to discover a new anti-inflammatory medication. Pharmacology developers noted that this new compound had strong anti-platelet properties. Starting in 1978 the drug was marketed in France under the brand name Ticlid for people at high risk for thrombotic events, who had just come out of heart surgery, were undergoing hemodialysis, had peripheral vascular disease, or who were otherwise at risk for strokes and ischemic heart disease. • Effectiveness of clopidogrel depends on activation to an active metabolite by the cytochrome P(CYP) 450 system, principally CYP2C19. in combination with aspirin (75 to 325 mg once daily) for patients with non-ST-segment elevation ACS (unstable angina, non-ST-elevation MI) Adults: 75 mg P. once daily in combination with aspirin (75 to 325 mg once daily), with or without a loading dose and with or without thrombolytics for patients with ST-elevation MI Use cautiously in: • thrombotic thrombocytopenic purpura • increased risk of bleeding • concomitant use of drugs that inhibit CYP2C19 (such as esomeprazole, omeprazole) • concomitant use of aspirin in patients with recent transient ischemic attack or cerebrovascular accident • premature discontinuation of drug • pregnant or breastfeeding patients • children (safety and efficacy not established). • Patients identified as CYP2C19 poor metabolizers treated with clopidogrel at recommended dosages exhibit higher cardiovascular event rates following acute coronary syndrome or percutaneous coronary intervention than patients with normal CYP2C19 function. CNS: depression, dizziness, fatigue, headache CV: chest pain, hypertension EENT: epistaxis, rhinitis GI: diarrhea, abdominal pain, dyspepsia, gastritis, GI bleeding Hematologic: bleeding, neutropenia, thrombotic thrombocytopenic purpura Metabolic: hypercholesterolemia, gout Musculoskeletal: joint pain, back pain Respiratory: cough, dyspnea, bronchitis, upper respiratory tract infection, bronchospasm Skin: pruritus, rash, angioedema Other: hypersensitivity reactions, anaphylactic reactions Drug-drug. • Tests are available to identify a patient's CYP2C19 genotype and can be used as an aid in determining therapeutic strategy. Abciximab, aspirin, eptifibatide, heparin, heparinoids, nonsteroidal anti-inflammatory drugs (NSAIDs), thrombolytics, ticlopidine, tirofiban, warfarin: increased risk of bleeding CYP2C19 inhibitors (such as esomeprazole, omeprazole): significantly reduced clopidogrel antiplatelet activity Fluvastatin, many NSAIDs, phenytoin, tamoxifen, tolbutamide, torsemide: interference with metabolism of these drugs Drug-diagnostic tests. • Consider alternative treatment or treatment strategies in patients identified as CYP2C19 poor metabolizers. Bilirubin, hepatic enzymes, nonprotein nitrogen, total cholesterol, uric acid: increased levels Platelets: decreased count Drug-herbs. Anise, arnica, chamomile, clove, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng: increased risk of bleeding • Monitor hemoglobin and hematocrit periodically. • Monitor patient for unusual bleeding or bruising; drug significantly increases risk of bleeding. • Assess for occult GI blood loss if patient is receiving naproxen concurrently with clopidogrel.

    Clopidogrel wikipedia

    Clopidogrel - Wikipedia, Ticlopidine - Wikipedia

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  3. Like the thienopyridines prasugrel, clopidogrel and ticlopidine, ticagrelor blocks adenosine diphosphate ADP receptors of subtype P2Y 12. In contrast to the other antiplatelet drugs, ticagrelor has a binding site different from ADP, making it an allosteric antagonist, and the blockage is reversible.

    • Ticagrelor - Wikipedia
    • Prasugrel - Wikipedia
    • Clopidogrel - DrugBank

    Торговое название Клопидогрел. Международное непатентованное название клопидогрел. Лекарственная форма таблетки, покрытые пленочной оболочкой. metformin 500 Clopidogrel, được bán dưới tên thương mại Plavix cùng với một số những tên khác, là thuốc kháng tiểu cầu được sử dụng để giảm nguy cơ bệnh tim và đột quỵ. Dual antiplatelet therapy. Often a combination of aspirin plus an ADP/P2Y inhibitor such as clopidogrel, prasugrel, ticagrelor, or another is used in order to obtain greater effectiveness than with either agent alone. This is known as "Dual antiplatelet therapy" or DAPT. Classification. The class of antiplatelet drugs include

     
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    Prophylaxis 80 mg/day PO divided q6-8hr initially; may be increased by 20-40 mg/day every 3-4 weeks; not to exceed 160-240 mg/day divided q6-8hr Inderal LA: 80 mg/day PO; maintenance: 160-240 mg/day Withdraw therapy if satisfactory response not seen after 6 weeks Hemangeol: Indicated for treatment of proliferating hemangioma requiring systemic therapy Initiate treatment at aged 5 weeks to 5 months Starting dose: 0.6 mg/kg (0.15 m L/kg) PO BID for 1 week, THEN increase dose to 1.1 mg/kg (0.3 m L/kg) BID; after 2 more weeks, increase to maintenance dose of 1.7 mg/kg (0.4 m L/kg) BID PO: 0.5-1 mg/kg/day divided q6-8hr; may be increased every 3-7 days; usual range: 2-6 mg/kg/day; not to exceed 16 mg/kg/day or 60 mg/day IV: 0.01-0.1 mg/kg over 10 minutes; repeat q6-8hr PRN; not to exceed 1 mg for infants or 3 mg for children PO: 1 mg/kg/day divided q6hr; after 1 week, may be increased by 1 mg/kg/day to maximum of 10-15 mg/kg/day if patient refractory; allow 24 hours between dosing changes IV: 0.01-0.2 mg/kg over 10 minutes; not to exceed 5 mg Immediate-release: 40 mg PO q12hr initially, increased every 3-7 days; maintenance: 80-240 mg PO q8-12hr; not to exceed 640 mg/day Inderal LA: 80 mg/day PO initially; maintenance: 120-160 mg/day; not to exceed 640 mg/day Inno Pran XL: 80 mg/day PO initially; may be increased every 2-3 weeks until response achieved; maintenance: not to exceed 120 mg/day PO Consider lower initial dose PO: 10 mg q6-8hr; may be increased every 3-7 days IV: 1-3 mg at 1 mg/min initially; repeat q2-5min to total of 5 mg Once response or maximum dose achieved, do not give additional dose for at least 4 hours Aggravated congestive heart failure Bradycardia Hypotension Arthropathy Raynaud phenomenon Hyper/hypoglycemia Depression Fatigue Insomnia Paresthesia Psychotic disorder Pruritus Nausea Vomiting Hyperlipidemia Hyperkalemia Cramping Bronchospasm Dyspnea Pulmonary edema Respiratory distress Wheezing Allergic: Hypersensitivity reactions, including anaphylactic/anaphylactoid; agranulocytosis, erythematous rash, fever with sore throat Skin: Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme, urticaria Musculoskeletal: Myopathy, myotonia May exacerbate ischemic heart disease after abrupt withdrawal Hypersensitivity to catecholamines has been observed during withdrawal Exacerbation of angina and, in some cases, myocardial infarction occurrence after abrupt discontinuance When discontinuing long-term administration of beta blockers (particularly with ischemic heart disease), gradually reduce dose over 1-2 weeks and carefully monitor If angina markedly worsens or acute coronary insufficiency develops, reinstate beta-blocker administration promptly, at least temporarily (in addition to other measures appropriate for unstable angina) Warn patients against interruption or discontinuance of beta-blocker therapy without physician advice Because coronary artery disease is common and may be unrecognized, slowly discontinue beta-blocker therapy, even in patients treated only for hypertension Asthma, COPD Severe sinus bradycardia or 2°/3° heart block (except in patients with functioning artificial pacemaker) Cardiogenic shock Uncompensated congestive heart failure Hypersensitivity Overt heart failure Sick sinus syndrome without permanent pacemaker Do not use Inno Pran XL in pediatric patients Long-term beta blocker therapy should not be routinely discontinued before major surgery; however, the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures Use caution in bronchospastic disease, cerebrovascular insufficiency, congestive heart failure, diabetes mellitus, hyperthyroidism/thyrotoxicosis, liver disease, renal impairment, peripheral vascular disease, myasthenic conditions Sudden discontinuance can exacerbate angina and lead to myocardial infarction Use in pheochromocytoma Increased risk of stroke after surgery Hypersensitivity reactions, including anaphylactic and anaphylactoid reactions, have been reported Cutaneous reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme, and urticaria, have been reported Exacerbation of myopathy and myotonia has been reported Less effective than thiazide diuretics in black and geriatric patients May worsen bradycardia or hypotension; monitor HR and BP Avoid beta blockers without alpha1-adrenergic receptor blocking activity in patients with prinzmetal variant angina; unopposed alpha-1 adrenergic receptors may worsen anginal symptoms May induce or exacerbate psoriasis; cause and effect not established Prevents the response of endogenous catecholamines to correct hypoglycemia and masks the adrenergic warning signs of hypoglycemia, particularly tachycardia, palpitations, and sweating May cause or worsen bradycardia or hypotension Pregnancy category: C; intrauterine growth retardation, small placentas, and congenital abnormalities reported, but no adequate and well-controlled studies conducted Lactation: Use is controversial; an insignificant amount is excreted in breast milk Nonselective beta adrenergic receptor blocker; competitive beta1 and beta2 receptor inhibition results in decreases in heart rate, myocardial contractility, myocardial oxygen demand, and blood pressure Class 2 antidysrhythmic Bioavailability: 30-70% (food increases bioavailability) Onset: Hypertension, 2-3 wk; beta blockade, 2-10 min (IV) or 1-2 hr (PO) Duration: 6-12 hr (immediate release); 24-27 hr (extended release) Peak plasma time: 1-4 hr (immediate release); 6-14 hr (extended release) Solution: Most common solvents Additive: Dobutamine, verapamil Syringe: Inamrinone, milrinone Y-site: Alteplase, fenoldopam, gatifloxacin, heparin, hydrocortisone, sodium succinate, inamrinone, linezolid, meperidine, milrinone, morphine, potassium chloride, propofol, tacrolimus, tirofiban, vitamins B and C IV administration rate should not exceed 1 mg/min IV dose is much smaller than oral dose Give by direct injection into large vessel or into tubing of free-flowing compatible IV solution Continuous IV infusion generally is not recommended The above information is provided for general informational and educational purposes only. 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