1- Indications:
A- Clopidogrel (Plavix):
* Severe arterial disease of lower members
* Ischemic stroke more than 7 days
* Unstable angina, myocardial
B- Persantine:
* Stroke Prevention
* Adjuvant treatment of coronary artery disease
C- Abciximab:
* Myocardial infarction
* Acute coronary syndrome with non-Q wave infarction
* Coronary Angioplasty
– Clopidogrel (Plavix®) -> ADP antagonist); ticlopidine (Ticlid)
– Dipyridamole (Persantine®) -> inhibiting the reuptake of adenosine (secondary effects: angina with coronary steal; vasodilation; bile calculated).
– GP IIb receptor antagonists / IIIb (Integrelin®) and Abciximab
2- Heparins:
A- information:
– Venous Thrombosis and Pulmonary Embolism
– Myocardial infarction in the acute phase
– Acute arterial obliteration members
– Original embolic stroke
– Substitution of AVK during pregnancy
B- Contraindications:
a- Absolute:
– Pericarditis; endocarditis; aortic dissection
– Hemorrhagic stroke
– Peptic ulcer recent
– Diabetic retinopathy
– Major hemorrhagic syndrome
– History of thrombocytopenia with heparin
b- Relatives:
– Liver failure
– Renal failure
– Honeymoon
– Severe hypertension
3- Fibrinolytics:
A- information:
– Myocardial infarction in the acute phase (before 12 hours)
– Massive pulmonary embolism
– Acute ischemia of the lower limbs
B- Absolute contraindications:
– AVC <2 months; intracranial pathology (neoplasia …)
– History of hemorrhagic stroke
– Pericarditis; endocarditis, and uncontrolled hypertension; A dissection
– Proliferative retinopathy; recent eye surgery
– Surgery <10 days (cerebro-spinal <2 months)
– Peptic ulcer
– Recent puncture (<48 hours) of an artery or of a compression member without possibility
– Severe hepatocellular insufficiency
– Other: malignancy; disorder of blood dyscrasias;
C- Relative contraindications:
– Fairly recent surgery (15 days)
– Recent puncture (48h) in a compressible territory
– History of gastrointestinal bleeding or PUD
– Strong external cardiac massage
– The valve prosthesis Dacron
– Hepatic Dysfunction