PROTOCOLS

CLOPIDOGRELDESCRIPTION:ALS PRACTITIONER PROTOCOLS• Classification : Platelet aggregation inhibitor• Schedule : 3PHARMACOLOGICAL ACTION:• Clopidogrel interferes with ADP binding to its platelet receptor, and thesubsequent ADP-mediated activation of the GPllb / llla complex, causingan irreversible, non-competitive inhibition of platelet aggregation,without influencing cyclo-oxygenase.• Clopidogrel also inhibits platelet aggregation induced by otheragonists by blocking amplification of platelet activation by released ADP.ADVERSE EFFECTS:• Haemorrhagic disorders and bleeding tendencies• Thrombotic thrombocytopenic purpura (TTP)• Gastro-intestinal disturbances – abdominal pain, dyspepsia, gastritis,constipation• Skin rash and pruritis• Hypersensitivity reactionsINDICATIONS:• Used as antiplatelet therapy ONLY in patients who have true aspirinallergy (who cannot tolerate aspirin) with suspected acute myocardialinfarction (acute coronary syndromes)CONTRA-INDICATIONS:• Known hypersensitivity / allergy to clopidogrel• Active pathological bleeding, e.g. actively bleeding peptic ulcer,intracranial haemorrhage• Safety and efficacy in children < 18 years not established (Not indicated)• Safety and efficacy in pregnancy and lactation not established44 SEPTEMBER 2006