Plavix

Description overdue on 29.01.2012

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Antiplatelet antiplatelet drugs . Main, an active substance - clopidogrel Which it is metabolized in the body to form the active form oksoklopidogrela (thiol derivative). The last binds to receptors on the surface Platelet . Normally these receptors sensitive to ADP ( adenosine diphosphate ), And after interaction with platelet ADP runs aggregation process Ie begins blood clotting   When oksoklopidogrelem bound receptors, platelet activation occurs, the processes of coagulation inhibited .  Clopidogrel platelet receptor interaction is irreversible, ie throughout the life of the platelet is inactive .  This explains the stable and reliable antiplatelet effect of the drug Plavix, which is achieved by the seventh day of the drug .  Later, as we update our pool of platelets to inhibit blood cells are replaced by new, and platelet activity is recovering at the same level .  Normal platelet aggregation is already fixed on the fifth day after the drug Plavix .  The drug is taken orally, its concentration in the blood plasma does not reach high numbers .  The metabolism of clopidogrel is carried out in the hepatic system, with urine and feces in about equal proportions .  The half-life oksoklopidogrela - 8:00 .

Indications:

Plavix is ​​widely used in neurology to prevent   thrombosis   patients with ischemic stroke . In this case, long-term clopidogrel is appointed, therapy lasts for about six months after suffering a violation cerebral circulation   (applies only in ischemic stroke!). Plavix is ​​widely used for the treatment of vascular disease ( peripheral arterial disease ). In cardiology actively include drug therapy in acute coronary events: in the treatment of myocardial infarction, acute coronary syndrome   no segment elevation on the electrocardiogram ST. In combination with aspirin, clopidogrel is used in the treatment of myocardial infarction without pathological Q wave on the electrocardiogram and in therapy unstable angina .

Contraindications:

Plavix is ​​contraindicated under the age of eighteen, when expressed allergic reactions to clopidogrel during pregnancy, breastfeeding a child. It is impossible to prescribe a drug for severe liver disease. As Plavix has a direct effect on the blood clotting system, assign it in the presence of acute bleeding ( peptic ulcer Complicated by bleeding, hemorrhagic stroke ) Is absolutely contraindicated. In addition, you may not assign Plavix in the first seven days (acute phase) ischemic stroke , Therapy can be started only after a week.

Side effect:

While taking Plavix may cause bleeding . Typically, they are found in the first 30 days of therapy. It was several deaths due to gastrointestinal and   intracranial bleeding . Registered bleeding into joints ( hemarthrosis ), Bleeding in the eyes (conjunctive, retinal, ocular), from the respiratory tract. On the part of the digestive tract   may develop side effects such as epigastric pain, nausea, vomiting, abnormal stools - how constipation And diarrhea . As severe complications can be called peptic ulcer, duodenal ulcer, inflammatory changes in the liver and pancreas. Nervous system   may respond to therapy with Plavix headaches, dizziness, dysgeusia in very rare cases confusion . From the blood   there may be a decrease in blood cell counts (as some of their species, and pancytopenia ) May develop arthralgia The appearance of the skin erythematous rash . itching . In some cases, there is violation of the urinary system.

Mode of application:

In order to prevent ischemic conditions in patients after myocardial infarction and ischemic stroke Plavix is ​​prescribed at a dose of 75 milligrams. Take once, the meal does not. A similar scheme is used in the treatment of peripheral arterial disease. In cardiology in acute coronary syndrome without ST-segment elevation receiving Plavix should start with a dose of 300 milligrams, and then you can move on to the standard dosage of 75 mg per day. At the same time prescribed acetylsalicylic acid . The course of treatment - up to one year.

Special instructions:

In case of overdose increases bleeding time. In order to quickly eliminate the effect of Plavix used a transfusion patient   platelets . No antidote. In the presence of patients with severe liver disease need to be vigilant, as the possible development of   hemorrhagic diathesis . Before surgery of any degree should stop taking Plavix for seven days in order to avoid complications and massive blood loss.

Drug Interactions:

In combination with warfarin use Plavix is ​​not recommended. Clopidogrel potentiates the effect of aspirin to reduce platelet aggregation induced by the interaction of platelets Collagen . At the same time, acetylsalicylic acid does not increase the inhibitory effect on platelet aggregation Plavix. Reception of both drugs at the same time during the year did not lead to negative effects. When receiving the drug Plavix heparin dosage adjustment is not required. Thus there is no data on the safety of the combination of heparin and Plavix, for simultaneous treatment with these drugs should be implemented very carefully. Heparin does not strengthen or weaken the effect of Plavix antiagregatine as fundamentally different effect on the coagulation system units. The combination of Plavix and naproxen   It increases the risk of developing gastrointestinal bleeding. Data about how dangerous it is in terms of bleeding in the digestive tract co-administration of adrenocortical hormones, and Plavix, no, but NSAIDs during treatment with Plavix must be assigned carefully. Drugs that reduce gastric acidity on the absorption of clopidogrel have no effect.