Antiplatelets - what do I need to know?

  1. For a patient on Plavix, for example, do I need to watch the coags just to make sure they don't go too high and cause severe bleeding?

    I know I need to be ready for signs of TTP and to keep track of the CBC (obviously including the platelet count), but I was wondering about the PT/INR and PTT, assuming the patient isn't on any concurrent blood thinner. How closely (often) do I need to watch these?

    How does aspirin factor in? Is it safe and generally accepted as normal to continue ASA maintenance therapy while on Plavix? What about use as an analgesic - teach the patient to stay away from all NSAIDs like I do with warfarin and heparin?

    Another question - how long after the initial bolus and d/cing the drip does tpa continue to exert an effect? What about reteplase? My understanding is that clearance is extremely fast so it shouldn't seem to be a danger for a long time, but better safe than sorry.
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