Pharmacologic Profile

General Use

Used to treat and prevent thromboembolic events such as stroke and MI.

General Action and Information

Inhibit platelet aggregation, prolong bleeding time, and are used to prevent MI or stroke (aspirin, clopidogrel, dipyridamole, ticlopidine, prasugrel, ticagrelor). Eptifibatide and tirofiban are used in the management of acute coronary syndromes. These agents are often used concurrently/sequentially with anticoagulants and thrombolytics.

Contraindications

Hypersensitivity, ulcer disease, active bleeding, and recent surgery.

Precautions

Use cautiously in patients at risk for bleeding (trauma, surgery). History of GI bleeding or ulcer disease. Safety not established in pregnancy, lactation, or children.

Interactions

Concurrent use with NSAIDs, heparin, thrombolytics, or warfarin, dabigatran, rivaroxaban, apixaban, edoxaban, or betrixaban may ↑ the risk of bleeding.

Nursing Implications

Assessment

• Assess patient for evidence of additional or ↑thrombosis. Symptoms will depend on area of involvement.
• Assess patient taking antiplatelet agents for symptoms of stroke, peripheral arterial disease, or MI periodically throughout therapy.

Potential Nursing Diagnoses

• Ineffective tissue perfusion (Indications)
• Risk for injury (Side Effects)
• Deficient knowledge related to disease processes and medication regimen (Patient/Family Teaching)

Implementation

• Use an infusion pump with continuous infusions to ensure accurate dosage.

Patient/Family Teaching

• Instruct patient to notify health care professional immediately if any bleeding is noted.

Evaluation/Desired Outcomes

• Prevention of stroke, MI, and vascular death in patients at risk.