The healthcare provider prescribes clopidogrel (Plavix) for a patient at risk for a myocardial infarction. While instructing the patient about the adverse effects and precautions associated with this drug, the nurse tells him that the following drugs should not be used while on clopidogrel unless the doctor is consulted. (Select all that apply.)
alteplase (Activase)
Diltiazem
Ibuprofen
Aspirin
Coumadin
Correct Answer : A,B,C,D,E
A. Alteplase (Activase): Alteplase is a thrombolytic agent used to dissolve blood clots. Concurrent use with clopidogrel, an antiplatelet medication, can increase the risk of bleeding due to additive effects on clotting. Therefore, it's important to consult the doctor before using these medications together.
B. Diltiazem: Diltiazem is a calcium channel blocker used to treat hypertension and certain heart rhythm disorders. Diltiazem will decrease the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Therefore, it's advisable to consult the doctor before using these medications together.
C. Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. Like other NSAIDs, it can increase the risk of bleeding when taken with clopidogrel. Therefore, it's important to consult the doctor before using these medications together.
D. Aspirin: Aspirin is another antiplatelet medication commonly used to prevent heart attacks and strokes. Combining clopidogrel with aspirin can increase the risk of bleeding without significantly improving outcomes in most cases. However, in some situations, such as after certain cardiac procedures, dual antiplatelet therapy (clopidogrel plus aspirin) may be prescribed under close medical supervision. Therefore, it's crucial to consult the doctor before using these medications together.
E. Coumadin (warfarin): Coumadin is an anticoagulant medication used to prevent blood clots. Concurrent use with clopidogrel can increase the risk of bleeding. Therefore, it's essential to consult the doctor before using these medications together.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Explanation
a. Hemostasis: Hemostasis refers to the process of stopping bleeding or preventing excessive blood loss. It involves several steps, including vasoconstriction, platelet aggregation, and clot formation. Hemostasis is the correct answer because it directly addresses the stopping of blood flow to protect the body from injury.
b. Thrombolytics: Thrombolytics are medications used to dissolve blood clots. They are not the natural mechanism for stopping blood flow. Thrombolytics are not the correct answer in this context.
c. Hematopoiesis: Hematopoiesis is the process of forming blood cells (including red blood cells, white blood cells, and platelets) in the bone marrow. It is essential for maintaining blood cell populations but does not directly stop blood flow. Hematopoiesis is not related to stopping blood flow.
d. Anticoagulation: Anticoagulation refers to preventing blood clot formation. While it is important for certain medical conditions, it does not directly stop blood flow. Anticoagulation is not the primary mechanism for stopping bleeding.
Correct Answer is C
Explanation
A. Ferrous sulfate: This is an iron supplement and wouldn't be used to reverse warfarin's anticoagulant effect.
B. Prednisone: This is a steroid medication used for various inflammatory conditions and wouldn't be used to address excessive blood thinning.
C. Vitamin K: Vitamin K is the antidote for warfarin poisoning or excessive anticoagulation. By providing vitamin K, the body can resume producing clotting factors, counteracting warfarin's effect.
D. Heparin: This is another blood thinner medication. While it can be used in specific situations, it wouldn't be the first choice to reverse warfarin's effect because it adds another layer of anticoagulation, which could be risky.
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