Plavix Washout

[guest2117]

Starting on a cardiac floor, was wondering what a plavix washout is. Thanks!

[Rose_Queen, BSN, MSN, RN]

It's the time needed to allow Plavix that the patient has taken to decrease to a certain level. Many times, if the patient is stable enough, the surgeons will wait for the effects of Plavix to wear off before the patient is considered ready for surgery.

[offlabel]

I work in cardiothoracic surgery and I've never heard that term before.

[Dodongo, APRN, NP]

Like Rose_Queen said, it's a term (not often used ) to denote the recommended hold time for anticoagulants/antiplatelet agents. It's all dependent on what the drug's MOA is, their half lives, the relative risk of the procedure, and surgeon preference.

This idea is generally much more important in the interventional suite than in the operative suite, as in interventional, the "operative field" is not open, so any unexpected bleeding events cannot be readily ligated.

[offlabel]

This idea is generally much more important in the interventional suite than in the operative suite, as in interventional, the "operative field" is not open, so any unexpected bleeding events cannot be readily ligated.

We hold Plavix, Coumadin, DTI's and XAI's for elective surgery. I've just never heard the term. It isn't used much, as you say, because it inaccurately implies some external process (wash out), and not the understood pharmacokinetics of the drug. Splitting hairs, but drugs don't "wash out", they have half lives.

[sevensonnets]

That's just two different ways of saying the same thing!

[Dodongo, APRN, NP]

We hold Plavix, Coumadin, DTI's and XAI's for elective surgery. I've just never heard the term. It isn't used much, as you say, because it inaccurately implies some external process (wash out), and not the understood pharmacokinetics of the drug. Splitting hairs, but drugs don't "wash out", they have half lives.

Typically, I've really only heard the term used by anesthesia providers discussing volatile anesthetics.

[guest2117]

Thanks everyone! I really appreciate it I couldn't find any info on google!

[offlabel]

Typically, I've really only heard the term used by anesthesia providers discussing volatile anesthetics.

Absolutely correct. And therein lies the distinction. The "washout" of volatile anesthetics occurs from turning off the vaporizer, turning up the oxygen flow thereby "washing out" the gas. It involves changing the concentration gradient of the gas from the blood to the alveoli, and that's for another thread, but the point is that the oxygen does the "washing". The gas doesn't get metabolized like a drug like Plavix.

[Ben_Dover]

We just call it "hold" or "suspend" or "dc" med.

[cardionurse36]

I work in CICU. We have patient's admitted to step down for plavix washout that are high risk for thromboembolic event. They are kept on a heparin drip while the placid works its way out of their system and the the heparin is generally stopped a few hours prior to the procedure since it has a short half life.