Atorvastatin + Clopidogrel + Aspirin Pharmacology
Atorvastatin + Clopidogrel + Aspirin
2.Acute coronary syndrome.
3.Hypertention
Atorvastatin
2.Dizziness
3.Insomnia
4.Alopecia
5.Anorexia
6.Abdominal discomfort
7.Heart burn
8.Abdominal pain
9.Nausea
10.Dyspepsia
11.Flatulence
12.Constipation
13.Abnormal liver function tests
14.Rash
15.Pruritus
16.Fatigue
17.Myositis
18.Chest pain
19.Impotence
20.Myopathy
21.Upper respiratory tract infections
2.Active liver diseases
3.Persistent elevation of serum transaminase levels
1.Monitor hepatic function tests and lipid levels before and periodically during therapy and stop drug if there is marked elevation of creatinine phosphokinase level
2.History of liver diseases
3.Alcoholics
4.In severe adverse effects and fever
Below 9years: Contraindicated
2.Combined hyperlipidaemia
Starts with 10mg once daily; Increased if required based on patients response.
Maximum dose: 80mg
Clopidogrel
2.Vomiting
3.Nausea
4.Abdominal pain
5.Headache
6.Tinnitus
7.Rash
8.Pruritus
9.Haemorrhage
10.Neutropenia (rare)
11.Thrombocytopenia (are)
2. Haemorrhagic disorders
3. Intracranial haemorrhage
4. Gastrointestinal tract ulcer
2.Renal impairment
3.Hepatic impairment
4.Trauma
5. Recent surgery
2. Thrombotic disorders
3. Prevention of stroke
4. Prophylaxis of myocardial infarction
5. Peripheral vascular diseases
6. Coronary artery diseases.
NSAIDs: Risk of increased occult gastrontestinal blood loss.
Phenytoin, tamoxifen, tolbutamide, warfarin, torsemide, fluvastatin: Since clopidogrel inhibits CYP4502C9 it may interfere with the metabolism of these drugs.
Aspirin
Peripheral action: It acts by inhibition of Prostaglandin (PGs) synthesis by blocking the activity of the precursor enzyme cyclo-oxygenase.
Anti-inflammatory action: It acts by inhibiting Prostaglandin (PGs) synthesis and their release at the site of injury. Prostaglandins cause tenderness and amplify the action of other algesics. Aspirin inhibits cyclo-oxygenase enzyme and antagonizes prostaglandin actions. It also inhibits other inflammatory mediators.
Antipyretic action: Aspirin lowers fever by affecting thermoregulation in the CNS and by inhibiting the action of prostaglandins peripherally. Aspirin inhibits the production of prostaglandin E1 which is the powerful pyretic agent.
Anticoagulant action: Aspirin inhibits the synthesis of Thromboxane A2 and Prostacyclin (PGI2). This leads to inhibition of platelet aggregation.
2.Vomiting,
3.Diarrhoea,
4.Gastrointestinal bleeding,
5.Abdominal distress,
6.Dyspepsia,
7.Dizziness,
8.Blurred vision,
9.Tinnitus,
10.Rash,
11.Pruritis
12.Ototoxicity
2.Peptic ulcer,
3.Bleeding disorders- Haemophilia, von Willebrand`s disease
4.Chicken pox and flu like syndrome in children
2.Renal impairment
3.Cardiovascular diseases- hypertension
4.Gastrointestinal diseases
5.Hypoprothrombinemia
6.Pre existing asthma
7.Patient on anticoagulant therapy
8.Diabetes
3rd trimester: Contraindicated
NEONATES: contraindicated
2.Ankylosing spondylitis,
3.Acute gout,
4.Joint disorders e.g. inflammatory disease in joints, crystal deposition in the joints,
5.Osteoarthritis,
6.For the relief of fever, pain and inflammation in dental, minor surgery and orthopedic
7.Dysmenorrhoea,
8.Rheumatic fever
9. Juvenile arthritis
10.Migraine
Activated charcoal: Decreases absorption of aspirin.
Antacids Urinary alkalizers and Cortiosteroids: Decrease efficacy of aspirin.
Drugs affected by aspirin:
Alcohol: Risk of G.I. ulceration increases; may also prolong bleeding time.
ACE inhibitors: Antihypertensive action decreased.
Oral Anticoagulants : May potentiate effect.
Methotrexate: Effect potentiated.
Tetracycline: Efficacy decreased.
Tricyclic Antidepressants - Effect potentiated.
Nitroglycerin: May result in unexpected hypotension.
Beta-adrenergic Blockers - Antihypertensive effect blunted.
NSAIDs: May decrease serum concentration.
Sulfonylureas and Exogenous Insulin: In high doses may potentiate these drugs.
Valproic Acid: Potentiates effect.
Spironolactone: May inhibit diuretic effect.
Probenecid & Sulfinpyrazone : Antagonise uricosuric effect (In doses > 3gm/day - uricosuric effect)
Lab Tests:
Thyroid Function Tests: Increase in PBI
Serum Uric Acid Levels: Increased by levels less than 10 mg/dl and decreased by levels> 10 mg/dl.
Urine Glucose: False negative by glucose oxidase method. False positive results by reduction method.
Urinary Ketones: Produce reddish colour.
Analgesic, antipyretic: 325 - 650mg 3 -4 times daily.
Anti-inflammatory, Arthritis: 3 g / day in divided doses increases the dose if needed.
Maintenance: 3.6 - 5.4 g / day in divided doses.
Rheumatic fever: 4.9 - 7.8 g / day in 3 - 4 divided doses for 1- 2 weeks
For prophylaxis of venous thromboembolism after total hip replacement: 650 mg twice a day started 1 day before surgery and continued for 2 weeks.
For other platelet aggregation inhibitory uses: 325 to 1300 mg daily according to individual needs.
For migraine: 300 - 600 mg to be taken at the first sign of migraine attack and repeated 4 - 6 hourly until suppress mild attacks.
Children:
Arthritis: 60 - 130 mg / kg body weight /day in divided doses
Anti-inflammatory: 60 - 125 mg / kg daily in 4 - 6 hours
Analgesic and Antipyretic: Adults: 1 to 2 tablets (325 to 650 mg) orally every 4 hours.
Children under 12: 10 to 15 mg/kg every 6 hours, not to exceed total daily dose of 2.4 g.
Home Delivery for Atorvastatin + Clopidogrel + Aspirin in Your City
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