Clopidogrel NSAIDs

Tenecteplase (TNKase) [Thrombolytic/Recombinant Tissue Plasminogen Activator] Uses Restore perfusion i mortality w/ AMI Action Thrombolytic TPA Dose 30-50 mg see Table III-l Caution [C, ], T Bleeding w/ NSAIDs, ticlopidine, clopidogrel, GPIIb/IIIa antagonists Contra Bleeding, CVA, major surgery (intracranial, intraspinal) or trauma w/in... 

Medications known to increase the risk of bleeding in cirrhotic patients include aspirin, clopidogrel, dipyridamole, corticosteroids, NSAIDs, heparin and warfarin. Mrs MW would need to be counselled about the risks associated with these medications and advised to always check with the pharmacist before buying any medications over the counter. 

NSAIDs Aspirin Clopidogrel Dipyridamole Warfarin Heparin SSRIs... 

Anticoagulant (warfarin) and antiplatelet agents (ticlopidine, clopidogrel) reduced platelet adhesiveness and G1 tract damage by NSAIDs increase risk of alimentary bleeding (notably with azapropazone). Phenylbutazone, and probably azapropazone, inhibit the metabolism of warfarin, increasing its effect. 

Garlic ASA, NSAIDs Clopidogrel, ticlopidine Warfarin Additive antiplatelet effects Additive antiplatelet effects Increased risk of bleeding... 

Ginseng ASA, NSAIDs Antidiabetic agents Clopidogrel, ticlopidine CNS stimulants, caffeine Corticosteroids Digoxin MAO inhibitors Warfarin Additive antiplatelet effects Additive hypoglycemia Additive antiplatelet effects Additive CNS toxicity Additive CNS toxicity Falsely elevated levels Increased toxicity Increased risk of bleeding... 

A. Classification and Prototypes Antiplatelet drugs include aspirin and other nonsteroidal anti-inflammatory dmgs (NSAIDs), dipyridamole and inhibitors of ADP receptors (ticlopidine and clopidogrel), and glycoprotein TIb/IIIa receptor inhibitors (abciximab, tirofiban, and epti-fibatide). These drugs increase bleeding time, a test used to monitor their effects. 

The manufacturers of clopidogrel warn about possible gastrointestinal bleeding if it is used with naproxen or other NSAIDs. There is also an increased risk of bleeding if ticlopidine is given with NSAIDs. 

Due to the lack of interaction studies with other NSAIDs, it is unclear whether there is an increased risk of gastrointestinal bleeding with all NSAIDs. The manufacturers advise caution if NSAIDs and clopidogrel are given together. ... 

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