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Clopidogrel Bisulfate

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Plavix

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Assessment & Drug Effects

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.

Patient & Family Education

Report promptly any unusual bleeding (e.g., black, tarry stools).

Avoid chronic aspirin or NSAID use unless approved by physician.

Do not breast feed while taking this drug.

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75 mg tablets

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Blood Formers, Coagulators, and Anticoagulants; Antiplatelet Agent

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Hypersensitivity to clopidogrel; intracranial hemorrhage, peptic ulcer, or any other active pathologic bleeding; pregnancy (category B). Discontinue clopidogrel 7 d before surgery and during lactation. Safety and efficacy not established in children.

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Inhibits platelet aggregation by selectively preventing the binding of adenosine diphosphate to its platelet receptor. It is an analog of ticlopidine. The drug's effect on the adenosine diphosphate receptor of a platelet is irreversible. Consequently, clopidrogrel prolongs bleeding time.

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Secondary prevention of MI, stroke, and vascular death in patients with recent MI, stroke, unstable angina or established peripheral arterial disease.

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Body as a Whole: Flu-like syndrome, fatigue, pain, arthralgia, back pain.
CV: Chest pain, edema, hypertension, thrombocytic purpura.
GI: Abdominal pain, dyspepsia, diarrhea, nausea, hypercholesterolemia.
Hematologic: Thrombotic thrombocytopenic purpura, epistaxis.
CNS: Headache, dizziness, depression.
Respiratory: URI, dyspnea, rhinitis, bronchitis, cough.
Skin: Rash, pruritus.

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Atorvastatin Calcium

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Lipitor

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10 mg, 20 mg, 40 mg tablets

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Atorvastatin is an inhibitor of reductase 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA), which is essential to hepatic production of cholesterol. Lipitor increases the number of hepatic low-density-lipid (LDL) receptors, thus increasing LDL uptake and catabolism of LDL. Atorvastatin reduces LDL and total triglyceride (TG) production as well as increases the plasma level of high-density lipids (HDL).

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Assessment & Drug Effects

Monitor for therapeutic effectiveness which is indicated by reduction in the level of LDL-C.

Lab tests: Monitor lipid levels within 2–4 wk after initiation of therapy or upon change in dosage; monitor liver functions at 6 and 12 wk after initiation or elevation of dose, and periodically thereafter.

Assess for muscle pain, tenderness, or weakness; and, if present, monitor CPK level (discontinue drug with marked elevations of CPK or if myopathy is suspected).

Monitor carefully for digoxin toxicity with concurrent digoxin use.

Patient & Family Education

Report promptly any of the following: Unexplained muscle pain, tenderness, or weakness, especially with fever or malaise; yellowing of skin or eyes; stomach pain with nausea, vomiting, or loss of appetite; skin rash or hives.

Do not take drug during pregnancy because it may cause birth defects. Immediately inform physician of a suspected or known pregnancy.

Inform physician regarding concurrent use of any of the following drugs: erythromycin, niacin, antifungals, or birth control pills.

Minimize alcohol intake while taking this drug.

Do not breast feed while taking this drug.

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Adjunct to diet for the reduction of LDL cholesterol and triglycerides in patients with primary hypercholesterolemia and mixed dyslipidemia.

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Cardiovascular Agent; Antilipemic Agent

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Hypersensitivity to atorvastatin, myopathy, active liver disease, unexplained persistent transaminase elevations, pregnancy (category X), lactation.

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Body as a Whole: Back pain, asthenia, hypersensitivity reaction, myalgia, rhabdomyolysis.
CNS: Headache.
GI: Abdominal pain, constipation, diarrhea, dyspepsia, flatulence, increased liver function tests.
Respiratory: Sinusitis, pharyngitis.
Skin: Rash.