Date:
28 March 2024
Page URL:
https://ntk.eastamb.nhs.uk/news/antiplatelet-regime-changes-for-patients-with-a-stemi-who-require-and-are-directly-transferred-to-ppci.htm?pr=
Following a review of evidence and engagement with regional cardiac specialist centres, the Trust is changing the antiplatelet regime for patients with a STEMI who require and are directly transferred to PPCI.
Clopidogrel will be replaced in drug bag pouches with a new drug called Ticagrelor.
This will be phased in on a rolling basis with each area coming online when a new delivery of medications arrives.
Once new pouches arrive, please swap these out and return the old ones.
This is straight swap-and-change in drug type and dose.
The indications are the same as for clopidogrel.
Below is full guidance for use. This will be added to the clinical manual app, but will not be in JRCALC pocketbooks.
Initially the below guidance will be included within the pouches.
Delivery and go live dates:
Clinical guideline for Ticagrelor: Published June 2021 |
|
Presentation |
90mg orodispersibale tablets |
Dose |
180mg - 2x 90mg dissolved in mouth and swallowed |
Indications |
Acute ST-elevation myocardial infarction indicated for transfer to PPCI secondary to administration of aspirin
|
Actions |
Inhibits platelet aggregation |
Contra-indications |
Known allergy to Ticagrelor Active bleeding History of intracranial haemorrhage Severe hepatic impairment
|
Cautions Unlikely a concern following single dose in an emergency |
Asthma, bradycardia (unless pacemaker fitted), COPD, hyperuricaemia, patients at increased risk of bleeding, second- or third-degree heart block (unless pacemaker fitted), sick sinus syndrome (unless pacemaker fitted), moderate hepatic impairment, pregnancy |
Side effects Unlikely following single dose in an emergency |
Constipation, diarrhoea, dyspepsia, dyspnoea, gout, gouty arthritis, bleeding, headache, hyperuricaemia, hypotension, nausea, skin reactions, syncope, vertigo.
Uncommon: Angioedema, confusion, intracranial haemorrhage, tumour haemorrhage, thrombotic thrombocytopenic purpura |
References: |
TICAGRELOR | Drug | BNF content published by NICE
Overview | Ticagrelor for the treatment of acute coronary syndromes | Guidance | NICE
|
Clinical grade |
Paramedic, Nurse, Doctor |
If you have any queries, please contact clinical.leads@eastamb.nhs.uk.