Ticlopidine 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... 

Abciximab, aminophylline, amiodarone, amrinone, aspirin, carbamazepine, chlorpromazine, danazol, diltiazem, eptifi-batide, heparin, histamine2-receptor antagonists, low molecular weight heparins, methyldopa, milrinone, procainamide, quinidine, quinine, NSAIDs, thiazide diuretics, ticlopidine, tirofiban, and valproic acid... 

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 UK manufacturer of ticlopidine warns that concurrent use of NSAIDs increases the risk of bleeding because there is an increase in platelet an-tiaggregant activity and because NSAIDs damage the gastro-duodenal lining, which can cause bleeding. They recommend that if NSAIDs are necessary, close clinical monitoring is advisable. ... 

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. 

Drugs implicated 3-Lactams other antibacterials NMBDs some NSAIDs quinolones mAbs proton pump inhib s P-Lactams quinine quinidine sulfonamides NSAIDs procainamide gold carbamazepine propylthiouracil ticlopidine P-Lactams ciprofloxacin sulfonamides lincomycin tetracycline NSAIDs carbamazepine allopurinol gold methyldopa mAbs NSAIDs p-lactams othCT antibiotics anti-convulsants antimalarials local anesthetics barbiturates quinolones dapsone... 

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