1. KAVITHA KANAKANTI

2.  To confirm the number of patients who were on Clopidogrel are taking Proton Pump Inhibitors.

3.  Numerous studies examined the clinical outcomes of patients taking clopidogrel and suggested that a significant interaction occurs between clopidogrel and PPIs, making clopidogrel less effective  One possible explanation for this observation is that some PPIs prevent the conversion of clopidogrel into its biologically active form in the body

4.  It reduces the effectiveness of clopidogrel and increasing the risk of heart attack or other conditions involving harmful clotting (e.g. strokes).

5.  The EU Committee for Medicinal Products for Human Use (CHMP) has stated that the concomitant use of a proton pump inhibitor (PPI) with clopidogrel is not recommended unless considered essential.

6.  The patients were chosen from the computer records who have been requesting repeat prescriptions of clopidogrel for the last 6 months  Medical records from this group of patients were checked manually if they were on PPI’s.

7.  62 patients were identified who were on Clopidogrel  Among these patients, 28 were also on PPI’s.  The medical records for these patients were highlighted with the information about interaction between clopidogrel and PPI’s.

8.  The interaction between clopidogrel and PPI’S to be discussed with the patient in the next appointment and PPI’s changed to appropriate drug depending on patients needs.  A re-audit need to be done to see if the action has been implemented in 6 months time.