| Term | Definition |
| Platelets (PLTs)
platelet aggregation inhibitors (antiplatelet agents) | Aspirin (ASA, NSAID- pharm class) anti platelet properties
Plavix (clopidogrel) |
| Mechanism of Action (1) | 1. Works in cyclooxygenase (COX) pathway in platelets --> inhibits formation of thromboxane A2
--> decreases vasoconstriction and platelet aggregation |
| Mechanism of Action (2) | 2. ADP inhibitor -->prevents platelet membrane from receiving to aggregate (glycoprotein IIb/IIIa receptor) |
| Therapeutic effect | Inhibits platelet aggregation |
| Indications | 1. Coronary Artery Disease (CAD)
2. Myocardial Infarction (MI)
3. Thrombotic storke |
| Precautions | 1. Bleeding
2. Clopidogrel-concurrent use with some proton pump inhibitors (PPIs) *Protonix (pantoprazole ok) |
| Contraindications | 1. Active bleeding; GI Ulcer; recent hemorrhagic stroke
2. Thrombocytopenia *decrease platelets |
| Side Affects | 1. Active bleeding: obvious/ occult
2. Thrombocytopenia *decrease platelets
3. GI upset |
| Nursing Actions | 1. Monitor bleeding
2. Follow CBC/ hemogram
3. Patient ed: drug/side effect, symptoms of bleeding, interactions. |
| Labs 1 | 1. Lipid Profile--- general recommendations |
| Lipid Profile a. | Total Cholesterol <200 |
| Lipid Profile b. | High density lipoprotein (HDL)
*women>50, men>60 |
| Lipid Profile c. | Low Density lipoprotein
< 120 |
| Lipid Profile d. | Triglicerides: <150 |
| Labs 2 | 2. Liver function tests (LFTs); serum glucose |
| Labs 3 | 3. Complete Blood Count (CBC)/ hemogram/ platelets |
| Labs 4 | 4. Hemocysteine, C --reactive protein (CRP) |
| CAD progresses | -->Coronary Ischemia (decrease blood flow and oxygen to myocardium) |
