Home Drug Guide Ticlopidine Hydrochloride

Drug Guide

Generic Name

Ticlopidine Hydrochloride

Brand Names Ticlid

Classification

Therapeutic: Antiplatelet agent

Pharmacological: Thienopyridine derivative

FDA Approved Indications

  • Prevention of stroke in patients at risk for arterial thrombotic events

Mechanism of Action

Ticlopidine inhibits ADP-induced platelet aggregation by irreversibly blocking the P2Y12 receptor on platelets, thereby reducing thrombus formation.

Dosage and Administration

Adult: Initial dose: 250 mg twice daily. Dose may be adjusted based on response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; consider age-related renal and hepatic function.

Renal Impairment: Adjust dosage based on renal function.

Hepatic Impairment: Use with caution; hepatic function should be monitored.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed to body tissues.

Metabolism: Extensively metabolized in the liver via CYP450 enzymes.

Excretion: Primarily excreted in the urine and feces.

Half Life: Approximately 4-6 hours, but platelet inhibition lasts for life of platelet (~7-10 days).

Contraindications

  • Active pathological bleeding (e.g., peptic ulcer, intracranial hemorrhage)

Precautions

  • Use cautiously in patients with bleeding disorders, hepatic impairment, or recent surgery.

Adverse Reactions - Common

  • Neutropenia (Less common)
  • Diarrhea (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Thrombocytopenia or Bleeding (Rare but serious)
  • Aplastic anemia (Very rare)
  • Liver toxicity (Rare)

Drug-Drug Interactions

  • Warfarin, other anticoagulants
  • NSAIDs, aspirin

Drug-Food Interactions

  • Alcohol may increase bleeding risk

Drug-Herb Interactions

  • Ginger, ginkgo biloba, which may increase bleeding

Nursing Implications

Assessment: Monitor signs of bleeding, complete blood counts, liver function tests.

Diagnoses:

  • Risk for bleeding

Implementation: Administer with food to reduce gastrointestinal upset. Monitor bleeding parameters.

Evaluation: Assess for signs of bleeding or adverse hematologic effects.

Patient/Family Teaching

  • Report signs of bleeding (bruising, bleeding gums, blood in stool or urine).
  • Inform about increased bleeding risk with trauma or surgery.
  • Avoid alcohol and NSAIDs unless directed by healthcare provider.

Special Considerations

Black Box Warnings:

  • Potential for neutropenia and aplastic anemia, which may be sudden and severe.

Genetic Factors: CYP2C19 metabolism may affect individual responses.

Lab Test Interference: May cause abnormalities in blood counts, liver function tests.

Overdose Management

Signs/Symptoms: Excessive bleeding, bruising, gastrointestinal bleeding.

Treatment: Discontinue medication, provide supportive care, and treat bleeding symptoms. No specific antidote.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable for 2 years when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.