Hematology and Oncology Book

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Clopidogrel

Aka: Clopidogrel, Plavix, Thienopyridine, Thiophene, Prasugrel, Effient
  1. See Also
    1. Antiplatelet Therapy for Vascular Disease
  2. Mechanism: Thienopyridine Class
    1. Blocks Platelet ADP
    2. Inhibits platelet aggregation
  3. Indications
    1. Cerebrovascular Accident Prevention
    2. Coronary Artery Disease Prevention
    3. Post-ST Elevation MI (with or without perfusion)
  4. Preparations
    1. Clopidogrel (Plavix)
    2. Prasugrel (Effient)
      1. Pending FDA approval in Summer 2008
      2. More effective than Plavix in cardiovascular event reduction
      3. Higher risk of bleeding than Plavix in age >75 years, weight <60 kg, CVA history
      4. Wiviott (2007) N Engl J Med 357(20):2001-15
  5. Advantages: Clopidogrel
    1. Less adverse effects than Ticlid
    2. Less GI Bleeding than Aspirin
      1. Option if GI Bleeding occurs with Aspirin
      2. Switch to Plavix does not prevent recurrent GI Bleed
        1. GI Bleed occurs in 8% of those switched to Plavix
        2. Consider adding PPI to Aspirin instead of Plavix
  6. Disadvantages
    1. Expensive ($125/month)
  7. Dosing
    1. Plavix 75 mg orally daily (consider initial 300 mg loading dose if age <75 years)

Plavix (C0633084)

Definition (CHV) a drug that prevents heart attack
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C055162
English Plavix, clopidogrel bisulfate (Plavix), BMS brand 1 of clopidogrel bisulfate, plavix
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Thiophene (C0599532)

Definition (CSP) 5-membered aromatic ring structure with a sulfur heteroatom.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
SnomedCT 12878005
English thiophene, thiofuran, thiole, Thiophene (substance), Thiophene
Spanish tiofeno (sustancia), tiofeno
Sources
Derived from the NIH UMLS (Unified Medical Language System)


clopidogrel (C0070166)

Definition (CHV) a kind of anticlotting drug
Definition (CSP) inhibits platelet aggregation
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C055162
SnomedCT 108979001, 386952008
English clopidogrel, CLOPIDOGREL, clopidogrel [Chemical/Ingredient], methyl 2-(2-chlorophenyl)-2-(4,5,6,7-tetrahydrothieno(3,2-c)pyridin-5-yl)acetate, Clopidogrel, Clopidogrel (product), Clopidogrel (substance)
Spanish clopidogrel (producto), clopidogrel (sustancia), clopidogrel
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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