rich01
Well-known member
A friend is taking Plavix and his arms are black from bruising. Any suggestions on alternatives he should discuss with his cardiologist? All I know is he has a couple of stents and had a heart ablation.
Alternative to Plavix
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pellicle
Professional Dingbat, Guru and Merkintologist
As an anticoagulant or as an antiplatelet? Well of course there's warfarin ;-) but that's not set and forget.
As someone who doesn't need that (can't use it) I don't have much on this; however this seems like its on the right path:
https://www.singlecare.com/blog/clopidogrel-alternatives/
Plavix inhibits platelets, the blood cells which form clots. As a member of the thienopyridine class, it does so by irreversibly binding to adenosine diphosphate (ADP) at the P2Y12 receptor. Brilinta and Effient are fellow class members and P2Y12 receptor antagonists as well. In the setting of both major types of heart attack, ST-elevation and non-ST-elevation myocardial infarctions (differentiated by presence or lack of ST-segment elevation on electrocardiogram), this drug category can be given as a loading dose to kick start the antiplatelet effect. Each P2Y12 inhibitor has nuances that may be appealing to you.
Platelet inhibition can be achieved by other mechanisms. Aspirin does so by inhibiting cyclooxygenase, dipyridamole by blocking adenosine uptake, and cilostazol by inhibiting phosphodiesterase 3. The end result of all of these is to reduce platelets from sticking together to form a clot. Alternatively, the anticoagulant Xarelto can be used at a low dose as a blood thinner for some of the same medical conditions. Whatever the category or mechanism of action, the important differences for you to consider involve factors like convenience, cost, effectiveness, drug interactions, and side effects.
Top 5 clopidogrel alternatives
As someone who doesn't need that (can't use it) I don't have much on this; however this seems like its on the right path:
https://www.singlecare.com/blog/clopidogrel-alternatives/
Plavix inhibits platelets, the blood cells which form clots. As a member of the thienopyridine class, it does so by irreversibly binding to adenosine diphosphate (ADP) at the P2Y12 receptor. Brilinta and Effient are fellow class members and P2Y12 receptor antagonists as well. In the setting of both major types of heart attack, ST-elevation and non-ST-elevation myocardial infarctions (differentiated by presence or lack of ST-segment elevation on electrocardiogram), this drug category can be given as a loading dose to kick start the antiplatelet effect. Each P2Y12 inhibitor has nuances that may be appealing to you.
Platelet inhibition can be achieved by other mechanisms. Aspirin does so by inhibiting cyclooxygenase, dipyridamole by blocking adenosine uptake, and cilostazol by inhibiting phosphodiesterase 3. The end result of all of these is to reduce platelets from sticking together to form a clot. Alternatively, the anticoagulant Xarelto can be used at a low dose as a blood thinner for some of the same medical conditions. Whatever the category or mechanism of action, the important differences for you to consider involve factors like convenience, cost, effectiveness, drug interactions, and side effects.
Top 5 clopidogrel alternatives
- Brilinta
- Effient
- Aspirin/dipyridamole
- Cilostazol
- Xarelto
slipkid
Well-known member
From what I understand without knowing the reasons behind it people that get stents get put on plavix for a period of time (usually a year) as a matter of one size fits all medical guidelines.
When I had two stents put in about 5 years ago, DESPITE already being on warfarin AND 81mg of aspirin daily I was put on Plavix for a year as well.
pellicle
Professional Dingbat, Guru and Merkintologist
Have to ask
WTF
slipkid
Well-known member
That's what I thought. I tried to ask the cardiologist at the time but he refused to answer any of my questions (starting with my simply asking "how long do I need to be on Plavix?"). He told me "I'm not going to answer any of your questions, go ask Dr. google".
At that point my primary physician told me to get a different cardiologist but honestly the next one (and his "train-station-turnstile-see-100-patients-a-minute office so you have no idea who they are or why they are seeing you) was much worse in how they approached EVERYTHING (read my echo wrong, entered my echo wrong in my chart as stress echo instead of regular resting one, showed total lack of any comprehension of what was going on in your office visit and on and on and on, etc).
Long stories behind all this but it illustrates perfectly my detest of Drs, most of whom that I've encountered do not want patients to ask them intelligent questions, but instead want the patient to do exactly as they say and never ever ever dare to correct them when they make a mistake or give out wrong information (again long story - or stories - there as well).
Anyways, back to plavix, from talking to other people I know who got stents every single one was put on plavix for at least a year, so I assume that is the standard procedure if a patient gets stents (I did read something that depending on the type of material in the stent sometimes it is less than a year), but I have no idea if that is supposed to be a general rule with no exceptions made if patient is also on warfarin or any other "blood thinning" type of protocol (as opposed to a Dr being lazy or making a mistake).
Wow! Very sad, very scary. The cardiologists I have dealt with in Iowa and Minnesota are all very willing to answer my questions. They've done this both during a visit, and via the medical system's secure message system.
I hope you can find a better cardiologist!
slipkid
Well-known member
pellicle
Professional Dingbat, Guru and Merkintologist
as long as you're getting basic readings done by the GP, perhaps that's all you need?
its sure what everyone got before I was born ...
¯\_(ツ)_/¯
Best Wishes
slipkid
Well-known member
My current GP is actually the worst "DR" ever. Not a DR btw, a Nurse Practitioner. Lazy as hell. Doesn't follow through on anything like he should (long stories). I'm pretty fedup with Drs/medicine in general. I need to find a new GP and Cardio but am so disgusted with things that have gone on in last 2 years or so my attitude is "eff it, I can't take struggling with these morons anymore".
pellicle
Professional Dingbat, Guru and Merkintologist
Hey mate I get it. I think it's really difficult in the modern world to try and balance the lack of people interested in being in medicine against the costs that are associated with the whole system, and that's exacerbated by a whole bunch of middlemen getting in the way and needing to get paid and a system that actually thinks the whole system itself is more important than the doctor and the patient.
I think also that from what I've seen the bigger and more bureaucratic the system is the worse it gets and the less possible it is to get rid of that massive bureaucratic impediment. hospitals are actually classic example of this the bigger the hospital the more power the hospital administrator has the more the hospital will attract the type of people in the top tier of medicine who are narcissistic and crave attention. This spirals out of control pretty quickly and there isn't really anything you can do about it, except dismantle it.
One of the first things that struck me when I was doing microbiology, as a first year student, was the every single thing that you shouldn't do if you wish to contain infection is actually what hospitals do. so for instance a nurse moving around the ward is a Vector for the transfer of infection. curtains that are around beds, are a classic way of distributing infections and it took until the naughties I think for them to figure that out.
Based on your profile I see that you live in a regional area, which is going to make it even harder. It'll be harder because as doctors become more narcissistic and more focused on producing money, for good reasons having seen a few glimpses of how the medical system works from the practitioner side in the United States from some of the doctors that I've dealt with here on the forum (yes I know there are no doctors on the forum). It's actually really hard for them financially because if they join a practice a really have to pay hard into it so until you become really successful it's just hard work. what this translates to for the patient is exactly what you seem to be experiencing.
So this leaves you suffering and while needing to find someone to help, also feeling defeated.
Here in my regional area we have a telehealth system which is sort of working and sort of not.
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slipkid
Well-known member
Speaking of microbiology. I really enjoyed the courses I had in that in college (I was a BIO major). Found it really interesting (that and genetics were my favorites). Always enjoy reading your scientific oriented posts...
Anyways, so last 12 years I had a horrible factory job, worked in Quality Control. The place was pretty gross in multiple ways. And with the horrible air circulation (basically was not any other than same air getting blown around all over the place), with a tiny breakroom with everyone in close corners, with filthy bathrooms, with common lockerrooms, with so much noise that you had to wear noise reducing ear protection so to speak to people you had to be right up in their face & vice versa, well every winter when colds and flu went around EVERYONE got sick. There was no escaping it.
Covid had a field day there and Management's "approach" to it was total b.s. (very long story). And an example you reminded me of with your post above about hospitals and vectors of infection - at the factory as a safety initiative to try to keep people getting run over by the marauding forklift drivers they put up various railings and swinging gates to get to some different areas of the factory. So everybody was TOUCHING these damn gates and spreading covid that way.
I pointed out to the Plant Manager that they had created yet another vector for passing covid around and that the gates served no real purpose anyways, we were still having near misses almost getting run over by forklifts, and if they REALLY wanted to do something to keep the people walking "safer" from the forklifts they should install bridges/steps over the forklift highways (like we had in one area at one time, which got destroyed by a forklift driver who crashed into it!). But he didn't want to listen to me.
Not that it really mattered I guess, we all got sick like crazy because of breathing the same air either on the factory floor (our crappy non-useful masks which many people wore on top of their heads or around their chins anyway) or in the breakroom/bathrooms where the masks came off, from touching the same things over and over again like machine controls, or the microwaves & vending machines, you name it).
But I guess we digress. Back to PLAVIX!
pellicle
Professional Dingbat, Guru and Merkintologist
your job sounds almost as fcked as when I used to deliver drums of (among other things) Hydrofluric acid to idiots (because there were no jobs in science research in the 1990's).
There isn't any real meaning to it all, except the meaning we ascribe.
Always a pleasure chatting
(*PS as aluminium cleaner)
personally I'm either helping someone or just looking around
There isn't any real meaning to it all, except the meaning we ascribe.
Always a pleasure chatting
(*PS as aluminium cleaner)
perrybucsdad
Well-known member
If you wish to move to the Cleveland Ohio area I can refer you to some fantastic doctors who always answer your questions.
I've had two awesome cardio docs. The one I had seen since I was 3 years old. He was a teacher as well, and he loved to teach his patients. I remember him teaching me how to identify my murmur when I was younger and the various heart sounds. He also taught me how to read my EKG (and gave me a copy of the book he coauthored). Unfortunately, I don't recall all that stuff, but I do still have his book. Sadly, he passed away a few years back, but the one who replaced him is almost just as good as him.
