Korean J Clin Pharm.  2018 Sep;28(3):250-253. 10.24304/kjcp.2018.28.3.250.

Bleeding after Taking Dual Antiplatelets and NSAID Concurrently

• Seo J
• Choi J
• Son P
• Lee S
• Chae H
• Kang G
• Ji E

• KMID: 2438552
• DOI: http://doi.org/10.24304/kjcp.2018.28.3.250

Abstract

When stenting is applied to treat myocardial infarction, antiplatelet agents are administered to prevent thrombosis, which increases the risk of bleeding. Patients with myocardial infarction are also more likely to have osteoarthritis simultaneously, because both diseases occur frequently in elderly patients. Patients with osteoarthritis often use analgesics, especially nonsteroidal anti-inflammatory drugs (NSAIDs); hence, patients with both diseases use analgesics and antiplatelet agents simultaneously. The risk of bleeding increases with the use of antiplatelet agents and this is further increased when NSAIDs are added. We would like to report a case that reflects this situation. A 60-year-old man underwent stenting after ST-elevation myocardial infarction, and was treated with aspirin and clopidogrel. This patient also received a pelubiprofen prescription from another physician to treat osteoarthritis. After the patient took pelubiprofen twice, he found a bruise on his wrist and reported it to the pharmacist. It is unlikely that this is rare in community pharmacies, so pharmacists should pay careful attention to the concomitant administration of analgesics to patients receiving antiplatelet agents and should provide appropriate education to patients.

Keyword

Bleeding; antiplatelet agents; NSAIDs; stenting; osteoarthritis

MeSH Terms

Aged
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Aspirin
Contusions
Education
Hemorrhage*
Humans
Middle Aged
Myocardial Infarction
Osteoarthritis
Pharmacies
Pharmacists
Platelet Aggregation Inhibitors
Prescriptions
Stents
Thrombosis
Wrist
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Aspirin
Platelet Aggregation Inhibitors