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Action: Uses: For patients with a Clopidogrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets. history of recent MI, recent CVA, established PAD, Plavix has been shown to reduce the rate of a combined endpoint of new ischemic stroke, new MI , and other vascular death. Clopidogrel Bicarbonate-Platelet Inhibitor Plavix, Clopivas, Zylitt, Clopidogrel, Laviguard Dosages: Adult: 300mg/day (loading dose; only for day 1); 75 mg/day Can be prescribed without a loading dose A: Bioavailibility <50% D: Protein Binding 9498% M: Hepatic E: 50% renal 46% biliary Routes: PO Onset: 2h Peak: 12 h (after initial dose) Duration: 24 h (after initial does) Half-life: (after initial dose) 6h; Common Side Effects: fever, diarrhea, taste disorders, hallucinations, headache, bronchospasms, generalized pruritus Adverse Effects: hepatic failure, hepatitis (non infectious), hemorrhage (often fatal hemorrhage: GI, cerebral, musculoskeletal, skin, respiratory tract, surgical wounds), FATAL intracranial bleeding, elevated creatinine levels, colitis, pancreatitis, pneumonia Contraindications: Plavix is contraindicated with persons with active bleeding, such as peptic ulcer; not to be used with tipinovir (a protease HIV medication); not to be used with proton pump inhibitors, such as acid relievers (this can affect how the drug is eliminated from your body); discuss use of NSAIDs and other aspirins with your provider prior to Plavix use Nursing Considerations: Educate patient on the risk for bleeds: avoid contact sports (bruising), caution use of sharp objects like razors (active bleeding); Carefully monitor for and immediately report S&S of GI bleeding, especially when coadministered with NSAIDs, aspirin, heparin, or warfarin. Lab tests: Periodic platelet count and lipid profile. Evaluate patients with unexplained fever or infection for myelotoxicity.