Exam Question of the Day - GYN 2-5-14

By drwall
February 5, 2014

The most common adverse reaction to therapy with clopidogrel (Plavix) involves which organ system?

A.Neurologic
B.Excretory
C.Hematopoietic
D.Cardiac
E.Gastrointestinal
Answer: C
Uptodate

Adverse Reactions Significant As with all drugs which may affect hemostasis, bleeding is associated with clopidogrel. Hemorrhage may occur at virtually any site. Risk is dependent on multiple variables, including the concurrent use of multiple agents which alter hemostasis and patient susceptibility.

3% to 10%:

Dermatologic: Rash (4%), pruritus (3%)

Hematologic: Bleeding (major 4%; minor 5%), purpura/bruising (5%), epistaxis (3%)

1% to 3%:

Gastrointestinal: GI hemorrhage (2%)

Hematologic: Hematoma

<1% (Limited to important or life-threatening): Acute liver failure, agranulocytosis, anaphylactoid reaction, angioedema, aplastic anemia, arthritis, bronchospasm, bullous eruption, colitis (including ulcerative or lymphocytic), creatinine increased, diarrhea, DRESS syndrome, duodenal ulcer, eosinophilic pneumonia, erythema multiforme, gastric ulcer, glomerulopathy, hallucination, hemophilia A (acquired), hemorrhagic stroke (≤0.2%), hepatitis, hypersensitivity reaction, interstitial pneumonitis, intracranial hemorrhage (≤0.4%), lichen planus, musculoskeletal bleeding, myalgia, ocular bleeding (including conjunctival and retinal), pancreatitis, pancytopenia, pulmonary hemorrhage, respiratory tract hemorrhage, retroperitoneal hemorrhage, serum sickness, Stevens-Johnson syndrome, stomatitis, thrombotic thrombocytopenic purpura (TTP), toxic epidermal necrolysis, vasculitis, wound hemorrhage

Contraindications Hypersensitivity to clopidogrel or any component of the formulation; active pathological bleeding such as peptic ulcer or intracranial hemorrhage

Canadian labeling: Additional contraindications (not in U.S. labeling): Significant liver impairment or cholestatic jaundice

Warnings/Precautions

Daily Exam Question - Written/MOC

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