The antiplatelet agent clopidogrel is commonly prescribed with a proton pump inhibitor (PPI) among cardiac patients to prevent gastrointestinal bleeding3 However, studies have suggested an increased risk for adverse cardiovascular outcomes when clopidogrel regimens are accompanied by PPI use; in 2009, the FDA released a warning regarding the combination. This final case study in a series of 3 features a 58-year-old male patient who is prescribed clopidogrel post-cardiac catheterization with stent placement, and begins taking an OTC PPI without consulting his clinician. The most recent data regarding the concomitant use of PPIs and clopidogrel is reviewed, and potential therapeutic strategies for this patient are outlined.
Nurse Practitioners, Primary Care Physicians, Physician Assistants
At the conclusion of this educational activity, participants should be better able to:Interpret the most recent data on the potential risks of concomitant use of clopidogrel and the various proton pump inhibitors (PPIs)Implement safe and effective strategies for treatment of gastroesophageal reflux disease (GERD) in patients who must take clopidogrel
AMA PRA Category 1 Credit(s)TM
Albert Einstein College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with the ACCME Essentials.
Albert Einstein College of Medicine designates this enduring educational activity for a maximum of .50 AMA PRA Category 1 Credits™. Each course participant should only claim credits commensurate with the extent of their participation in the activity.
CME COURSE REVIEWER
Lawrence J. Brandt, MD
Emeritus Chief, Division of Gastroenterology
Montefiore Medical Center
Albert Einstein College of Medicine
Professor of Medicine and Surgery
Albert Einstein College of Medicine
A. Michael Lincoff, MD
Director, C5 Research
Director, Center for Clinical Research and Vice Chairman for Clinical Research
Lerner Research Institute
Vice Chairman, Department of Cardiovascular Medicine
Professor of Medicine
Lerner College of Medicine of Case Western Reserve University
Conflict of Interest Disclosure Statement
The “Conflict of Interest Disclosure Policy” of Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical or equipment company. Any presenter whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity, or who refuses to provide all their conflict-of-interest information, will not be permitted to present.
Lawrence J. Brandt, MD, has nothing to disclose with regard to commercial support.
A. Michael Lincoff, MD is a consultant for and receives grant/research support from AstraZeneca.
Publishing Staff Disclosures
Marjorie Hale, Lori Marrese, and Krista Sierra of Haymarket Medical Education have nothing to disclose with regard to commercial support.
Disclosure of Unlabeled Use
This educational activity may contain discussion of approved and/or investigational uses of agents that are not indicated by the FDA. Albert Einstein College of Medicine of Yeshiva University, Takeda Pharmaceuticals North America, Inc., and HME do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Albert Einstein College of Medicine of Yeshiva University, Takeda Pharmaceuticals North America, Inc., and HME. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
This program is sponsored by Albert Einstein College of Medicine of Yeshiva University.
If you have any questions relating to the accreditation of this activity, please contact Mildred Shields Adighiuzor, Associate Director of CME Marketing, Albert Einstein College of Medicine, at (718) 920-6674.
Supported by an educational grant from Takeda Pharmaceuticals North America, Inc.
Produced by Haymarket Medical Education
To obtain credit, a score of 70% or better is required. This CE is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test survey, and have received your digital copy of your credit certificate. Your online certificate will be saved on myCME.com within your Profile/Exam History, which you can then access at any time.
WINDOWS PC SYSTEM REQUIREMENTS:
266-MHz Pentium II; Windows 98 or higher; 64 MB RAM; 800 x 600 screen resolution
set for “High Color (16-Bit)”; Macromedia Flash Player 6 or higher.
MACINTOSH® SYSTEM REQUIREMENTS:
Power Mac g3 at 300 MHz; System 8.5 or higher (excluding Mac OSX); 96 MB RAM; 20
MB minimum hard disk space available; 800 x 600 screen resolution set to “Thousands
of Colors”; Macromedia Flash Player 6 or higher.