Clopidogrel

Clopidogrel reduces the rate of cerebrovascular and cardiovascular events in patients with acute coronary syndrome (ACS), recent acute myocardial infarction (AMI) or stroke, and those with peripheral artery disease. Clopidogrel itself is a pro-drug that need to converse to active form through CYP2C19. This has led to significant concern that drugs inhibiting CYP2C19 (like PPIs) might reduce clopidogrel’s effectiveness. 1 Siller-Matula et al conducted a meta-analysis study to evaluate whether PPIs negatively affect clinical outcome (combined major adverse cardiac events, myocardial infarction, stent thrombosis, death and gastrointestinal bleeding) in patients (n=159,138) treated with clopidogrel. Patients use clopidogrel with PPI was associated with a 29% relative risk increase (RR=1.29; 95% CI=1.12-1.53) of combined major cardiovascular events and a 31% relative risk increase of MI (RR=1.31, 95% CI=1.12-1.53) vs. no PPI use. In addition, patient use clopidogrel with PPI was not associated with mortality (RR=1.04, 95% CI=0.93-1.16). 2 Bhatt et al conducted a prospective…

Clopidogrel resistance is associated with great adverse outcomes, early recognition of these patients is very important. However the major problem in this issue is the lack of standardized method and cut-off values in definition of clopidogrel resistance. A few methods have been used but none have been fully standardized or fully agreed upon to measure clopidogrel responsiveness [52]. As discussed above platelet function tests are expensive ,time consuming and complicated , however this…

Overview: The combination of many issues such as prescriptions cost, patients’ economic status, and lack of health insurance, interfere with the patients’ access to their medications. This creates an environmental problem that puts patients at a higher risk for morbidity and mortality, and consequently, increasing the healthcare cost of treatments on health complications due to non-medication compliance (Duke, Raube, & Lipton, 2005, p. 726). Approximately 50 million people in the United States…

Bristol Meyers Squibb is a pharmaceutical company, with a very rich tradition. This analysis will begin with a few historical highlights. Edward Squibb was a doctor in the Navy, who was unimpressed by the medicine that the Navy was using during the Mexican War, he was so dissatisfied that he threw all of the unfit medicine overboard. On 1858, when he returned, he went on to start his own company in Brooklyn, New York, with the goal of having pure medicine for the people. Squibb’s medicine was…

I. INTRODUCTION: Clopidogrel is one of the major drugs used in the treatment of Acute Coronary Syndrome. Along with Aspirin it is the standard of care in Percutaneous Coronary Interventions with stenting, when a long term dual antiplatelet treatment is needed. However the response to clopidogrel shows wide inter-individual variations. Various studies have shown that the polymorphisms in the genes responsible for Clopidogrel absorption and metabolism are a major factor for these variations.…

Critique of Systematic Reviews Two systematic review articles will be critiqued and compared in this paper. Article A is titled systematic review and meta-analysis of adverse events of low-dose aspirin and clopidogrel in randomized controlled trials authored by Kenneth McQuaid and Loren Laine. Article B is titled platelet function testing in transient ischemic attack and ischemic stroke: a comprehensive systematic review of the literature by Soon Lim, Catherine Coughlan, Stephen Murphy, Israel…

Include antiplatelet and statin in managing patients with carotid artery stenosis and stroke. For patients with stroke secondary to 50% - 99% occlusion of a major intracranial artery, aspirin 325 mg/d is preferred to warfarin. Clopidogrel + Aspirin 325 x 90 days may be used in patients with recent stroke or within the last 30 days caused by 70% - 90% stenosis of a major intracranial artery. Do not…

interactions). Proton pump inhibitors causes few adverse effects with its usage such as upper abdominal pain, dry mouth, constipation, vomiting. dizziness, headache and flatulence but evidence is mounting that these medications can also lead to some troublesome and even serious adverse drug reactions such as bone fractures, hypomagnesmia, community acquired pneumoniae, vitamin B12 malabsorption,clostridium difficile associated diarrhoea. In 124 patients with coronary artery disease (CAD)…

“Clopidogrel is a drug used to inhibit blood clots for those patients suffering from coronary artery disease and other circulatory diseases leading to strokes and heart attacks” (Christopher Wanjek, 2011). Smoking seems to help this drug do its job better by working as a synergist. “A study by Korean researchers in the October 2010 issue of the journal Thrombosis Research stated that something in cigarette smoke activates certain proteins called cytochromes. It converts clopidogrel into a more…

The medications he takes are Metoprolol, Valsartan, Amiodarone, Atorvastatin, Clopidogrel, Metformin and Rivaroxaban. He takes the same three medications for three years now and the same four medications since his bypass surgery. Today, he chooses to have a lively life with an excellent diet and exercise habits. Medication Evaluation My participant, JR had heart bypass surgery, exactly 4 bypasses, on June 1, 2015, due to 90% of his coronary arteries being blocked. This eight-hour surgery was a…