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DAY 4, WEEK 2 (DRP) - Coggle Diagram
DAY 4, WEEK 2 (DRP)
- Inappropriate regimen of bisoprolol
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Justification
Bisoprolol has long-half life (9-12 hours) thus, can be administered once daily to reduce the need for multiple doses
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Outcome
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Monitoring: Heart rate, Blood pressure & Blood glucose
- Inappropriate Drug Choice of Clopidogrel
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Justification
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Adenosine diphosphate (ADP) antagonists, a class of therapeutic agents that bind selectively to the P2Y12 receptor to inhibit platelet function.
The degree of platelet inhibition remained markedly different from clopidogrel and favoring prasugrel
Outcome
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Complete blood counts with differential, bleeding time, and liver function tests.
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- Rationale of using Pantoprazole in patient receiving DAPT
Patient receiving dual antiplatelet therapy may have a high risk to obtain gastrointestinal bleeding
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Justification
Currently, there is an issue arise on the uses of Proton pump inhibitor will reduce the antiplatelet effect of clopidogrel.
This agent is said to be competitively inhibit CYP2C19 (enzyme that metabolized clopidogrel to its active form), thus reduce the antiplatelet effect.
However, the present study showed that pantoprazole does not reduce the antiplatelet effectiveness of clopidogrel as it is a weak inhibitor of CYP2C19.
The short-term application of pantoprazole reduced the risk of gastrointestinal bleeding but did not increase the incidence of MACE events in patients with acute STEMI, thus being worth extending clinically, especially for high-risk patients
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