Clopidogrel works by antagonizing ADP receptors in order to prevent ADP mediated aggregation. These effects are irreversible and last the full lifespan of the platelet.
By blocking ADP receptors, clopidogrel prevents ADP regulated aggregation. These effects are irreversible and last the entire lifespan of the platelet, approximately 3-7 days.
Due to clopidogrel anti-thrombotic properties, it may be indicated for the management of acute coronary syndrome because this medication prevents blockages from forming within coronary arteries.
As an antiplatelet medication, clopidogrel is used to prevent thrombotic events, such as myocardial infarction and ischemia. For those who do not tolerate aspirin well, this medication can be used as a second line of treatment.
One of the main complications related to clopidogrel is hemorrhage. This occurs due to the antiplatelet properties of the medication. The patient taking clopidogrel should be on bleeding precautions and should be closely monitored for signs of bleeding. Further, clopidogrel should be monitored closely, if used with other drugs that promote bleeding.
Thrombotic thrombocytopenic purpura is a serious complication that may occur due to use of clopidogrel. This side effect can cause small blood clots to form within the small vessels of the body leading to issues related to organ function. Patients should be monitored closely for signs of TTP including: bruising, kidney failure, fever, anemia, thrombocytopenia, and neurological symptoms.
Pancytopenia, which includes thrombocytopenia, leukopenia, and anemia, may occur with use of clopidogrel. For this reason, complete blood counts (CBC) should be closely monitored in patients receiving clopidogrel.
Clopidogrel is absorbed in the gastrointestinal tract; therefore, it may cause abdominal pain related to GI bleeding. Patients taking clopidogrel should be monitored for abdominal pain and other signs of GI bleeding, such as blood in the feces.
Due to the increased risk of bleeding from decreased formation of platelets, clopidogrel should be withheld 5 days before elective surgery to decrease the risk of hemorrhage during surgery. Some patients are kept on clopidogrel and the bleeding is managed, as discontinuing the medication may lead to a thrombotic episode.
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